Clinical DIMENSIONElectrocardiogram Lead Selection Using Critical Thinking Concerning Women and Heart Disease and a Case of Wellens SyndromeMoseley, Marthe J. PhD, RN, CCRN, CCNS, CNL; Allen, David MSN, RN, CCRN, CCNS; Martell, Maximino MSN, RN, CNS-BC, CCNS, CCRN Author Information Marthe J. Moseley, PhD, RN, CCRN, CCNS, CNL, is the associate director clinical practice in the Office of Nursing Services for the Department of Veterans Affairs, Washington, DC and clinical nurse advisor for Cardiovascular. Dr Moseley serves as a member of the editorial board for Dimensions of Critical Care Nursing. David Allen, MSN, RN, CCRN, CCNS, is a major of the US Army Nurse Corps and is a clinical nurse specialist for the Burn Center of the Institute of Surgical Research in Ft Sam Houston, Texas. Maximino Martell, MSN, RN, CNS-BC, CCNS, CCRN, is a Major of the US Army Nurse Corps and is a Clinical Nurse Specialist at the Critical Care Nursing Services, Brooke Army Medical Center in Ft Sam Houston, Texas. Address correspondence and reprint requests to: Marthe J. Moseley, PhD, RN, CCRN, CCNS, CNL ([email protected]). The opinions or assertions contained herein are the private views of the author and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense. Dimensions of Critical Care Nursing: November 2010 - Volume 29 - Issue 6 - p 253-258 doi: 10.1097/DCC.0b013e3181f0b7db Buy Metrics AbstractIn Brief 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. Understanding that significant electrocardiographic changes can occur in the absence of chest pain can present a challenge. This article will discuss the leading cause of death of women in the United States-heart disease. The physiology of Wellens Syndrome is also presented along with recommendations for critical care nurses. © 2010 Lippincott Williams & Wilkins, Inc.