Learning to read ECGs again, online

Originally published in GP magazine .

Written for GP magazine around 2009. This is the version I submitted - the published article may have been edited.

I’ve always considered myself quite good at reading ECGs, having worked as a cardiology registrar in a former life. However, while researching some questions for an MCQ app I am writing for the iPhone, I realised I had forgotten quite a lot. Given the changes to revalidation I thought this would be a good thing to revise this year, but instead of pulling out my old textbooks I decided to see what was available online, and was amazed at the quality of what’s available - and am jealous of today’s medical student who has access to such high-quality free education.

Typing ‘ECG’ or ‘ECG quiz’ into Google brings up a range of sites as a start. The sites vary from a collection of interesting ECGs to complete online courses. Most sites assume you know nothing and start with the basics. Of course there are several American sites, though you have to type in EKG to get them!

One of my favourite sites is www.ecgpedia.org, a wiki-style site run by the Dutch CardioNetworks foundation, a non-profit-making organisation. The site is very comprehensive, aiming to be a complete course, and is free to use. They have a one-page pocket guide to reading ECGs that you can download and print off, and they have invested in a lot of good artwork. As well as having lots of real ECGs, the artwork shows most abnormalities in simplified form, which makes it easy to understand what it should look like without having to view a wiggly trace that is poorly scanned in. They have also recently introduced some animations to their site. They have an axis calculator that is great: as you move the dial around it shows how the various leads change, and this really helps you understand what is going on. Being a wiki, you can get involved - see their site for details.

Closer to home is www.ecglibrary.com, a website run by Dr Dean Jenkins. It is simpler in design but does have a list of most common and some uncommon abnormal ECGs, with good examples to view. Both Ecglibrary and Ecgpedia are happy for people to download or otherwise use their pictures and contents for educational uses, including using them in your own presentations, as long as you credit the source.

There are lots of other sites online, and some medical schools have excellent sections on ECGs, including this Liverpool University site, www.liv.ac.uk/csrc/e-learning/ecg/index.htm, which has some great artwork as well.

Other sites include: sprojects.mmi.mcgill.ca/heart/egcyhome.html, www.12leadecg.com and library.med.utah.edu/kw/ecg/index.html.

If you aren’t good at reading information on screens - and I often get lost in the non-linear structure of some websites - how about watching a video on how to read an ECG? Amazingly, several people have gone to the trouble of recording lectures, and these are freely viewable on YouTube.

Try typing in ECG or ECG course and loads come up. Some are two-minute clips of abnormal ECGs, but some are half-hour-long lectures. Quality of image and sound does vary, but they are watchable and some are very informative.