see also:
| condition | duration |
|---|---|
| possible cardiac chest pain | until 2nd trop is normal unless high risk features mandate further monitoring |
| hyperkalaemia | until K+ < 6.5 |
| acute pulmonary oedema | |
| acute coronary syndrome | 24hrs from onset of pain and then reassess |
| STEMI or non-STE-ACS | |
| life threatening arrhythmias: | 24hrs from onset |
| post cardiac arrest | |
| VF / V flutter | |
| asystole | |
| VT | |
| accessory pathway (eg. WPW) with rapid vent. response tachycardias | |
| syncope or tachycardia or bradycardia with haemodynamic compromise possibly due to primary cardiac condition | excl. vasovagal, hypovolaemia, etc |
| temporary cardiac pacing | |
| Mobitz II or 3rd degree AV blocks | |
| Long QTc syndrome with ventricular arryhythmia | |
| new RAF in pts with certain heart diseases (eg. HOCM) where new onset AF may be lethal | |
| pharmacologic | |
| IV cardiac drug Rx such as inotropes, vasoactive drugs, type I/III antiarrhythmic agents (amiodarone, sotalol, quinidine, procainamide, lignocaine, phenytoin, flecainide, propafenone) | |
| overdose of substance with potential pro-arrhythmic effects (eg. VT, prolonged QTc) as per toxicologist or cardiologist | |
| condition | duration |
|---|---|
| delayed presentation NSTEMI | cease once troponins negative or after 24hrs whichever is earlier |
| post-op patients at high risk of ischaemia | |
| AF with rapid ventricular response | until HR < 120 |
| syncope with no obvious cause, especially in the elderly or with either: LBBB; RBBB+fasc. block; QRS >= 0.12sec; Mobitz I; HR < 50; sinus pause > 3sec; pre-excited QRS complexes; Brugada syndrome; Q waves suggesting AMI; possible arrhythmogenic RV dysplasia (neg. T waves R precordial leads, epsilon waves, ventricular late potentials); vent. dysplasia | excl. vasovagal, postural, micturition, carotid sinus syncope, POTS, autonomic failure, hypovolaemic |
| significant risk of resp. or cardiac arrest | |
| pericarditis | |
| large perocardial effusion | |
| suspected cardiac blunt trauma | |
| stable patients with PVCs | |
| very high voltage electrocution | |
| electrocution with abnormal ECG or cardiac symptoms | |
| chronic AF with haemodynamic compromise |
| chronic AF on iv digoxin loading |
| chronic AF without haemodynamic compromise |
| asymptomatic 1st degree heart block |
| patients with a stable, functioning ICD or PPM which has been checked |
| raised troponin due to non-coronary ischaemia (although these patients may need ICU/HDU for undelying issue) |
| household voltage or lower voltage electrocution / electrical injury with normal ECG and no cardiac symptoms |