EKGs

I love EKGs. They're so much fun, and that's one of the reasons why cardiology was always on my list of specialties. EKGs are amazing because they're an easy, cheap, non-invasive test and they can reveal an enormous amount of information about the heart. But even more than that, I think they're wonderful because the amount of information in an EKG varies by one's experience. As a first year medical student, I could decipher basics of a rhythm strip and perhaps make a stab at axis. By third year, I was able to identify some rudimentary arrhythmias and take a shot at signs of ischemia. Now on my cardiology rotation, I return to the same EKGs but notice atrial or ventricular enlargement, bundle branch blocks, and some common patterns like pulmonary embolus. A resident and then attending reading the EKGs can tease out even more subtleties. I like that about electrocardiograms. Anyone can take a shot and get something useful from an EKG, but as one's refinement increases, she can mine more information and do it more efficiently. This is in contrast (no pun intended) to say, an MRI of the brain where non-radiologists and non-neurologists can glean very little or a lab value where there is no puzzle to be deciphered.

We have EKG reading three times a week with a community cardiologist and it's very fun. I've realized each preceptor has a different approach to the EKG and much can be learned from all of them. I really like the systematic aspect of the EKG, and it feels like learning a new language. The EKGs we read are real EKGs rather than a learning set and though that can be frustrating (there are artifacts, leads are switched, multiple pathologies may be going on at once), it's starting to become very rewarding.

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