Three case studies in this article demonstrate the use of a protocol for continuous ST-segment monitoring among patients in intensive care units and progressive care units.

For patients in intensive care units (ICUs) and progressive care units (PCUs), a particular area of interest in the cardiac waveform is the ST segment. Depression or elevation of the ST portion of the waveform in at least 2 electrocardiography (ECG) leads that view the same surface of the heart indicates possible ischemia and resulting risk for myocardial infarction or death.1 Recently, an expert consensus document2 was published that provided a universal definition of myocardial infarction, giving specific guidelines regarding the degree of changes in the ST segment that are significant. For example, new ST-segment depression of only 0.5 mm or more in 2 contiguous leads meets criteria for potential manifestation of acute myocardial ischemia (in absence of left ventricular hypertrophy and...

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