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Electrocardiogram Lead Selection Using Critical Thinking: Concerning Women and Heart Disease and a Case of Wellens Syndrome

When a patient enters the acute or critical care environment, it is imperative that the nurse select the best lead for monitoring the patient based on initial interpretation of the 12-lead electrocardiogram. Understanding that significant electrocardiogram changes can occur in the absence of chest pain presents a challenge, supporting the need for ongoing vigilant monitoring throughout the critical care stay. The purposes of this article were to (1) discuss the leading cause of death in the United States, (2) highlight the significance related to the population of women, and (3) present the physiology of Wellens syndrome along with monitoring recommendations to prevent unexpected outcomes for this patient population. A case study of Wellens syndrome is included.