Monitoring
The duration of cardiac monitoring is generally dictated by the clinical condition, symptoms, presence of ischemia, and arrhythmias.
The duration of cardiac monitoring after percutaneous coronary intervention depends on the presence or absence of ongoing ischemia, and hemodynamic or electrical instability. In general after successful revascularization of all ischemic lesions, monitoring should be continued for >12-24 hours and in cases without revascularization, it should be continued for >24-48 hours.[108]
Patients with non-ST-elevation acute coronary syndromes (NSTE-ACS) should be monitored in the coronary care unit; however, those with UA (troponin negative) without recurrent or ongoing symptoms and normal ECG can be monitored on a regular floor.[1]
Low-risk patients are defined by the absence of recurrent chest pain, ECG changes, serum cardiac markers, and findings of heart failure.[174] These patients should undergo noninvasive testing (using either exercise or pharmacologic stress, and echo or nuclear imaging modalities) prior to hospital discharge and require aggressive risk-factor modification.
Patients initially treated conservatively should be reevaluated 2 to 6 weeks after discharge. They should be assessed for cardiac catheterization and revascularization, based on symptoms and noninvasive testing.
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