150 ECG Problems strips and their associated case histories challenge readers to formulate diagnoses for a wide variety of cardiac abnormalities
Learning about ECG interpretation from books such as The ECG Made Easy or The ECG in Practice is fine so far as it goes, but it never goes far enough. As with most of medicine, there is no substitute for experience, and to make the best use of the ECG there is no substitute for reviewing large numbers of them. ECGs need to be seen in the context of the patient from whom they were recorded. You have to learn to appreciate the variations both of normality and of the patterns associated with different diseases, and to think about how the ECG can help patient management.
Although no book can substitute for practical experience, 250 ECG Problems goes a stage nearer the clinical world than books that simply aim to teach ECG interpretation. It presents 150 clinical problems in the shape of simple case histories, together with the relevant ECG. It invites the reader to interpret the ECG in the light of the clinical evidence provided, and to decide on a course of action before looking at the answer. Having seen the answers, the reader may feel the need for more information, so each one is crossreferenced to The ECG Made Easy or The ECG in Practice.
The ECGs in 250 ECG Problems range from the simple to the complex. About one-third of the problems are of a standard that a medical student should be able to cope with, and will be answered correctly by anyone who has read The ECG Made Easy. A house officer, specialist nurse or paramedic should get another third right, and will certainly be able to do so if they have read The ECG in Practice. The remainder should challenge the MRCP candidate. As a very rough guide to the level of difficulty, each answer is given one, two or three stars (see the summary box of each answer): one star represents the easiest records, and three stars the most difficult.
The ECGs are arranged in random order, not in order of difficulty: this is to maintain interest and to challenge the reader to attempt an interpretation before looking at the star rating. This is, after all, the real-life situation: one never knows which patient will be easy and which will be difficult to diagnose or treat.
150 ECG Problems is the successor to 100 ECG Problems, published in 1997. The popularity of the latter has encouraged me to include more examples of common abnormalities and also some problems for which there was previously no space. I hope the reader will find 250 ECG Problems an entertaining and an easy way to learn and revise.