EKG Learning on a Budget, Or: High-Stakes Sudoku for the Emergency Physician
If you are like me, your introduction to EKGs in medical school consisted of reading one of either
Rapid Interpretation of EKGs or The Only EKG Book You’ll Ever Need. Also if you’re like me you probably
felt like you couldn’t interpret EKGs particularly speedily and that it was likely going to take another
book (or two) to get you there after reading those. After some looking around on the internet I
stumbled on a blog post from the nice folks at Rosh Review entitled “How I Learned to Read ECGs Better
than a Cardiologist”. The post is highly worth a read but the books recommended in the post—while
mostly fantastic—can be a bit cost-prohibitive. Garcia’s 12 Lead ECG: The Art of Interpretation is hands-
down my favorite book to learn EKG interpretation, but a copy will set you back about $80 for a used
book. In that spirit I wanted to try to compile a list of resources that can be found online which are, if
not free, at least cheaper overall than the traditional textbook approach as outlined in the Rosh post.
Here are my top five
Disclaimer: I have no financial conflict of interest in any of the previously mentioned products nor
those to follow.
Life in the Fast Lane
https://litfl.com/ecg-library/
The work done by the creators of Life in the Fast Lane’s ECG library is incredible, and free!
Chances are that if you are reading this you have probably already heard of LITFL. The amount of
information presented can be pretty intimidating but it’s a fantastic reference. LITFL also has the benefit
of being more EM/Crit Care inclined than some of the other resources on ECGs out there.
ECG Wave-Maven
https://ecg.bidmc.harvard.edu/maven/mavenmain.asp
ECG Wave-Maven is an educational resource put out by Harvard which is also free! After
providing your level of training you can access their library of 600ish ECG cases. The format here is
question/answer with the didactic portion only available at the end, so if you are trying to learn as-you-
go this website can be a bit daunting. It also does not have a specific EM focus so if you work through the
cases in order you will learn some fantastic information that you may never use. (Ever diagnosed an LV
aneurysm based on the El-Sherif Sign? No???) There is the option to view the various cases by topic and
difficulty level so if you wanted to pick a topic to read up on at LITFL you could come over to ECG Wave-
Maven to drill down on various examples.
Dr. Smith’s ECG Blog
http://hqmeded-ecg.blogspot.com/
Dr. Smith’s ECG Blog. While not normally what I would consider a resource for beginners, I think this blog is
important for learners from the late-beginner stage and on. He will push you no matter what stage of learning
you are at. Once a bit more practiced at evaluating EKGs for ischemia you’ll find a link to his book (also for free!)
on the website which is solely dedicated to evaluating EKGs for MI. There’s also a 40 minute lecture just on T
wave inversions. Good for a deep dive if there was a section on LITFL or ECG Wave-Maven that you wanted to
cover in more detail specific to an EM context. EKG nerd paradise, but will lead to some serious squinting and
brow-furrowing. Keep ibuprofen handy whilst reading.
On to some not so free resources:
EKG DX
https://www.ekgdx.com/
This is a pretty interesting concept for EKG learning but a bit less intuitive than other resources. For
a monthly subscription fee of $5 or $10 this site will let you generate a sample EKG depending on the
pathology you want to study. The generated EKGs are interactive and very well labeled which is nice if
you’ve ever wondered where exactly one segment stops and another begins. The various pathologic
EKGs offer detailed explanations as well as citations for the various learning points they present.
When looking at infarction EKGs you can pull up both cardiac catheter images and a 3d heart
rendering to really get a feel for how the leads correlate to the coronary arteries and myocardial
anatomy which is pretty sweet. So far there aren’t side-by-side echo images showing wall motion
abnormalities by infarct territory but the website does have an echo image library so that might be
coming somewhere down the line. All in all a cool resource but not entirely relevant to the EM scope of
practice.
ECG Weekly
https://ecgweekly.com/
Another fantastic blog by an EM EKG giant. Dr. Mattu’s videos have a Bob Ross-ian style that makes
EKGs feel approachable while making you want to see how everything comes together (and every P
wave needs a happy little QRS friend). While not free, at $26/year it’s pretty close, and the EKGs are
presented as clinical cases that are very EM relevant. If you are still trying to learn the basics this might
not be the best place to start due to the case-style format, but a fantastic place to reinforce a topic.
Happy Learning!
Wes Priddy, MD
USF Emergency Medicine Class of 2022
About the author:
Dr. Wesley Priddy graduated from USF’s Morsani College of Medicine and now is a resident at the USF
Emergency Medicine program. He is originally from southern California and is interested in toxicology,
EKG interpretation, and making tacos.
Post edited by Dr. Michael Weaver