Learning about ECG interpretation from books such as The ECG Made Easy or The ECG in Practice is fine as 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.
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ECGs need to be interpreted in the context of the patient from whom they were recorded. You need to learn to appreciate the variations 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 be a substitute for practical experience, 150 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 then 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 cross-referenced to The ECG Made Easy and/or The ECG in Practice.
The ECGs in 150 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 should be answered correctly by anyone who has read The ECG Made Easy. A junior doctor, specialist nurse or paramedic should get another third right, 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 of each problem, each answer is graded using 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, to maintain the reader’s interest. Readers are invited to attempt their own interpretation before looking at the star rating – after all, in a real-life situation one never knows which patient will be easy and which will be difficult to diagnose or treat. In this fourth edition there are many new ECGs, mainly to provide examples that reproduce more clearly. However, to maintain the “real world”
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