Customer Reviews

Challenging ECGs

5 star:		(1)
4 star:		(0)
3 star:		(0)
2 star:		(0)
1 star:		(0)

 

 

The book is a pretty straightforward collection of ECG's put together by Dr. Marriott from his own collection and those of his colleagues. There aren't many frills to the book outside of the tracings and comments. It is setup with an ECG on the left hand page, and facing, on the opposite page, an interpretation from Dr. Marriott along with any clinical information he happened to have on hand from when the ECG was recorded. While it features a few classic examples of ECG patterns, mostly, as the title implies, it contains some of the more complex ECG cases you'll ever encounter.

Although Dr. Marriott initially considered assembling the book with the cases mixed at random, he instead decided to break it up into eight sections roughly categorizing the ECGs by their chief disturbance. This has its pros and cons: While it's nice to have all the cases together when you really want to practice a certain topic, such as wide-complex rhythms, if you're also looking to quiz yourself as you systematically work through the entire book, having a bunch of cases with similar features together gives you an unfair crutch. When you're in the Escape and Dissociation section, you already know to look for the underlying rhythms and signs of dissociation, rather than looking at each case as a blank slate, which would be a lot more challenging. I think the solution for that is to go through the entire book one time so that you see every case at least once, and then, as your memory of the cases fades, occasionally open to a random page and see how you fare. Of course, being tough cases, most of the ECG's have several factors that could affect where they end up being organized, but I think most of the classifications make sense and flow nicely. Additionally, there is an index where you can find cases based on more specific factors, like if you wanted to look up all the ECGs with signs of cor-pulmonale, or track down a case you recall of a patient with myxedema.

While you can find some very extensive collections of ECGs online, what you're paying for with this book is tracings selected and interpreted by a master of electrocardiography. While some cases feature little in clinical information or comments beyond the diagnoses of the tracings, it is balanced by others containing pearls and insightful comments into how Dr. Marriot came to his interpretation. Additionally, you get to compare your own diagnosis with that of Dr. Marriott, which will either make you feel great when you're in agreement, or woefully inadequate when he showcases an understanding of the tracings a cut above the average provider. This is definitely not a book for anyone just learning to do ECG's; there's simply too much going on with each tracing to get any useful learning when 5 of the 8 diagnoses on an ECG are new concepts or features you missed. If you want to get the most out of it, I especially recommend Marriott's "Practical Electrocardiography," simply because it introduces you to how Dr. Marriott approaches electrocardiography and gets you comfortable with his language for describing ECG phenomena. While Chou's text is equally enlightening, they sometimes use different language for similar ECG features, so it's helpful to know exactly what Marriott is saying when he uses certain terminology. Additionally, he occasionally mentions features or diagnosis criteria you wouldn't be able to reference unless you had his text available, although, for the most part, he does a good job reviewing whatever background knowledge would aid with a diagnosis on more complex tracings. The pair, however, really do make a useful combo, allowing you to test yourself on a tracing in this book, while also referencing a more in-depth discussion of an ECG feature in his text, all while using the same terminology and approach to electrocardiography that really makes the topic mesh.

While there are a wealth of sources out there for learning and practicing ECG interpretation, I find this book to be highly useful for raising my understanding to the next level, while also showcasing some fascinating tracings you won't see anywhere else. It's a challenging collection you can come back to again and again, and I highly recommend it for anyone with an interest in getting the most out of the 12-lead ECGs they encounter.