Free ECG lessons

[mariop]

This site has a nice tutorial on ECG.  You can download the file to your computer and read it at leasure.

http://library.med.utah.edu/kw/ecg/index.html

[CollegeGirl143]

just curious.. why do you think a patient would ever need a tutorial on how to interpret that kind of information?? Dont you think a licensed professional would be a better qualified to interpret that kind of data?

[Momto3]

I voted for the licenses professional.  I've been told that EKG's can be very tricky to decipher.  Aside from spitting out "computer generated" diagnoses, there are soooo many variants to interpretating an EKG.  I'll leave that to the cardio.

[va_tony]

Yes, of course, a medical professional will always do a better job interpreting ekgs; (even better than a computer diagnostic program).  On the other hand, I think it would be useful to have a rudimentary understanding of ekgs, the origin of the electrical signals in the heart, and how the ekg is used to diagnose problems. It helps to educate yourself on the heart's electrical workings so that you can better understand and assist the cardiologist in choosing a treatment option best for your arrhythmia.

[mariop]

You have to actually work with health care professionals in a hospital setting to witness what goes on.  It may help to also have familiarity with malpractice claims to see misinterpretations of readings of films; in many cases they are simply done by rookies and signed off by radiologist.

It may also help if you actually knew someone who was harmed by medical practice and you came to realize how little resources there are to help such victims.

As a start you may want to look at these two links:

http://www.smartmoney.com/10things/index.cfm?story=october2006

http://www.smartmoney.com/consumer/index.cfm?story=tenthings-july02

Over and above this, a person might simply want to know how to read them because their curiosity is more unlimited.

[CollegeGirl143]

"It helps to educate yourself on the heart's electrical workings so that you can better understand and assist the cardiologist in choosing a treatment option best for your arrhythmia"

... Or confuse yourself! LOL.. Its hard to even get a rudimentary understanding that is quite complex.. I agree, basic knowledge of the heart as an organ, of course, is never a bad thing to have, but this type of knowledge doesnt make a lay person qualified to diagnose or even attempt to diagnose ones self, or really go about chosing treatment options for oneself....Chosing your treatment should be based on your physician(s)knowledge and your personal preference..Best left to the professionals..

[CollegeGirl143]

just wanted to add..

posts have been removed, and users be banned for posting links as its against the terms and conditions here without prior consent.. Dont want to see helpful people get banned for this :)

[mariop]

Come on CollegeGirl, be more radical!  Sometimes the risks are worth taking.

Thanks for the reminder anyway.

[CollegeGirl143]

What is life without risks eh? Health though is one thing i personally dont like to take risks with though :) thats pretty much the ultimate risk, LOL..

If you wanna play the ponys though, im all over it :-P

[va_tony]

"... Or confuse yourself! ."

I disagree.  If motivated, a layperson can learn an amazing amount of material and develop considerable insights, especially with respect to their own body. Non-MD laypeople (albeitusually  Ph.D's in another discipline) frequently win the Nobel Prize in Medicine even.

[Barbarella]

Momto3:  You're right about "Computerized EKG diagnosis".  I was in the ER at one time and my EKG stated that I had a previous MI.  You can imagine the shock I was in.  Not the ER doctor nor the Cardiologist who was called could tell me if this was an error by the EKG machine or what.  I was discharged from the ER and referred to a Cardiologist for "further tests to see if I indeed had a previous MI".  The next appointment with the Cardiologist was 6 weeks off, then came all the tests just to be told by the Cardiologist "I'm so tired of these computerized EKG's spitting out all these false heart attacks, your heart is fine, don't worry you are in excellent shape".  I then told the Cardiologist "if so many computerized EKG's spit out FALSE heart attacks then why don't you medical professionals go to the bottom of it and tell the manufactorers who make these computerized EKG's to get to the bottom of what causes these machines to spit out these false heart attacks"?  Or go back to the old EKG's but to put people in suspense for 6 weeks till the next available appointment thinking they had a heart attack, the computer could not tell "when" the so called FALSE heart attack happened is a joke.

I still got a copy of this piece of **** EKG, and I will refuse all "routine EKG's" I don't need that.  If I had been an isolated case or one of very few cases that would be one thing, but to be told by a Cardiologist that "he is getting tired of all these FALSE heart attacks coming out of these computers I think its time that they do something about that i.e. find out the cause.

But then again, hooking up the patients to all kinds of test to prove that the computerized EKG is/.was wrong brings in money.  Was I given a second EKG at the ER?  Nooooo, I was told to make an appointment with a Cardiologist.  Maybe the second EKG would not have spitted out a false MI.  BTW, all my other EKG's outside of the ER thereafter were normal

mariop:  How do you sue a computerized EKG for malpractice??  I guess you could sue them for not getting to the bottom of what causes the "so many false heart attacks the Cardiologist is getting tirerd of "  as I was told.

[CollegeGirl143]

we're just going to have to agree to disagree here :) .. i dont have to explain to you under what premises a person of a non medical profession would gain national recognition for a "medical discovery" worthy of a nobel prize, No, you do not need an MD to understand medicine, but the people of which you speak have degree's and phd's and extensive professional education in other areas of science,(such as genetics, biology, microbiology ect ect) they are not people sitting at home trying to learn medicine on the internet :) ... It is one thing to try and memorize medical terms and facts, its quite another to take that "knowledge" out of your mind and try and put it to use, which is why we have medical schools and licensing for medical professionals.

[Al Dente]

There are some interesting points being raised here.  On one side, we have the public that has an interest and a right to know information regarding their care, and healthcare in general.  On the other, we have a perception that only "medically trained professionals" (this can be people that attend technical schools looking at your info to nurses, PAs, or physicians).

The danger lies with self diagnoses, anxiety, or spreading wrong information.  People, as they naturally want to help solve problems with their health, gather and learn--however they must do so in a level that is appropriate to them.

One can educate themselves from well documented sites on the internet, books (readily available texts at large booksellers), or from their own personal experiences.  A couple years of undergradute sciences gives a person a good base.  Add graduate experience and understanding how to do research & analysis, you can have a very knowledgable person.

Reading EKGs (and unless you have a cardio or electro pouring over your stuff) your most likely getting machine readings.  I don't see alot of cardios doing the math over EKGs...Your family practice guy isn't the expert.

A person with some knowledge can learn to spot skips on monitors, or even AFIB quite easily.  I think one should defer ultimately to professionals--however mistakes are made.

There is nothing wrong with educating oneself regarding one's healthcare.  I think it smacks of hubris when people feel only  "medical people" should have access and education.  There are alot of bright people out there that aren't physicians that can pull a case together, while their own docs can't.

I'm looking from both sides here, as a patient that seeks high quality care, and one that has had serious mistakes in judgement and treatment by these highly trained medical professionals.

A sign of a good doc too, if they know you are intested in health, will ask you "what have you learned from your last visit?"  Patients that are educated can have much more successful and meaningful visits with their healthcare providers.

Given, I must concur that this only can be effective if the person has a good educational & science base, and understands the logic in the process.

[CollegeGirl143]

The danger lies with self diagnoses, anxiety, or spreading wrong information. People, as they naturally want to help solve problems with their health, gather and learn--however they must do so in a level that is appropriate to them....

Completely agree with you on that point.. Ide just also like to add, While having a bad experience with a trained professional should be motivation to learn how to find a more experienced physician, i dont think its cause to pour over medical journals or websites in an attempt to begin to self diagnose, i also personally cannot think of a reason a patient would need a monitor and learn to interpret data unless they where trying to self diagnose..Curiosity, yes, but in my opinion that form of curiosity can be dangerous... Im sure many people want to take the drivers seat when it comes to their health, its hard to put something so important in the hands of a stranger, however this is nessecary... I dont think medical education or literature should only be accessable by medical professionals, i do however believe medical knowledge/procedure/or tests should only be implimented by medical professionals, if this werent the case, why bother to have physicians? Where does one draw the line? between trying to teach yourself how to read your own ekg's, to say trying to teach yourself open heart surgery? both can have some pretty serious consiquences.

"Given, I must concur that this only can be effective if the person has a good educational & science base, and understands the logic in the process."

I agree here too.. a formal traditional education preferrable.. Self education leaves too much room open for interpretation, and leaves you with no guiding hand to explain theories and give one correction.

[va_tony]

You've explained both sides very well Al. I can't disagree with anything you've said

I guess I suffer from hubris too.  As a Ph.D. in physics and a scientific researcher with 40 years experience and over 100 peer-reviewed journal articles under my belt, I just assume that if I wanted to learn about ekg interpretation, I could do so provided I put in the necessary effort.

I also have a high regard for many of the people on this board and figure they are bright enough to learn enough to help in assessing their treatment options.

Regards

Tony

[mariop]

Let's face it CollegeGirl, some of us have either experienced or witnessed the failure of the medical system.  Doctors cut corners just like home builders.  I worked for 35 years in a hospital system and I can tell you that I dealt with cases where the surgeon amputated the wrong leg, or operated on the wrong patient.

Harvard Medical School put out a study about 5 years ago where it was shown that some 150 thousand patients a year are harmed by the medical system.  Therefore it is healthy to have a certain amount of rational distrust.  Sure I want to trust doctors, but if I can I also want to verify.

[CollegeGirl143]

i completely understand your concern mariop... Verification is definatly nessecary to some people, which is why we have the options of such things as specialists and second opinions.. If you'de like to have the knowledge nessecary to test such or verify such things yourself, there are certifcations and degrees that can be had that would make this a realistic possibility..

Mariop, va, And Al :) Ide like to ask you all a simple question... Do you for example consider yourselves qualified enough to interpret ekg strips for strangers and other patients, and by this interpretation only, suggest, or discourage any kind of treatment? Im assuming no since this would likely get one sued..

Ide hope that you would give yourselves the same treatment that you would a stranger and not put them or yourselves in danger by doing this...  The point here is, no matter how strong your science or education background is, unless its specific, its just that, a background.. Unless you have formal training, you are not qualified to make such interpretations and suggestions to anyone, including yourselves, unless of course you are interpreting your own data with a physician present giving strong guidance and explanation. :)  It is however your health, and your risks :)

[lilCharlie]

I think it would be kind of neat to be able to look at your EKG and sort of know what your looking at!  We all get an explaination from the doctor, but so often you see people post here on Medhelp asking others thier opinion.  Nobody is obviously qualified to interpret them other than a trained professional, but its still interesting that there is a site that can explain some basics!  Good find! :)

[Momto3]

WOW!  Great thread and lots of good comments!!  

There are certainly two sides to every coin and it is good to investigate both sides.  

Although I do not intend to fully study or learn how to interpret an EKG, I will continue to ask questions, read and learn whatever I can.  

Kudos to all of us who choose to live and learn!

[CollegeGirl143]

thats a great policy :) its always important to be comfortable, ask questions, and even learn specifics about your own conditions with the guidance of a qualified person, but this is another area that gets fuzzy, as we've all seen the people affected by say, something benign like palps or svt, who read something untrue on the internet, or misinterpret a study, and it sends them into a downward spiral that many take months or years to recover from, because they dont have a professional there to explain to them why what their looking at doesnt apply to them, and while they may understand the "basics" they lack the knowledge to understand fully whats going on within their bodies, and its quite scary, and it leads to alot of heartache and misinformation (like this "6 palps in a row" rumor that will not die)

With EKG's its particularly sketchy because they are programmed at certain levels to make a diagnoses based solely on heart rate, and can often spit out false positives, such as the case when a heart rate is over 175, most ekg's automatically diagnose svt... Or for "diagnosis" Of wide complex SVT, which is extremely hard to decifer from VT... it is common for a diagnosis wcsvt to actually be a vt..or ashman beats will commonly be misdiagnosed as well.. there are a million things, that take years of study to learn, and frankly, you cannot teach yourself...  I personally find it impossible to teach yourself something that you dont know, if you have no mathmatical history, would you try and teach yourself calculus?

.... Theres just a thin line between the natural urge to learn about yourself, and self diagnosing/self testing, which can be a big big gamble and lead to alot of trouble

[maggiemag]

I think it's great when people want to learn more about their condition.  To me it is a must to learn as much as I can.  It's when they decide that they know more than the professionals that I have a major problem.  As brilliant as one might be, there is still no substitute for years of experience.  Distrust of the medical system after one decides that they were wronged is no excuse; sorry, just my $.02!

[Al Dente]

CollegeGirl makes alot of good sense, and there are very some other good posts too...VA Tony has some valid points.

I think patients should educate themselves to a safe level, and if their mindset & education permits, all the better.

CollegeGirl, this gets quite difficult for patients that have symptoms and their questions aren't being answered to their satisfaction.  Your question to me earlier was loaded 8 ^).....I say this, I'll research and learn as much as I can.  I have discussed misdiagnoses with my physicians with information that I've gained to overall make an accurate diagnoses and treatment plan.

People with complex dieseases & cases need support.  When you're getting billed at level 4 of 5 or 5 of 5, these are complex cases.  Patients that take 10-20 medications have alot of issues to deal with, and many physicians don't deeply understand or explain the effects--they leave that to you as they figure you're going to get on the internet anyway to learn about.

Misdiagnoses itself is very destructive.  Uncovering physician and technical errors takes time & resources.  A complex case can have numerous opinions, all of which point to every direction of the compass.

As has been well discussed, the danger of self diagnosis and preoccupation is not a good situation.  Being well informed and knowledgable can help treat the case.  However, the medical community does not understand or is unwilling to tollerate those who do educate themselves and learn.

Those who've gone down the cardiac road know when it's time to get the docs involved, or just chill----getting to that point takes more than "it's harmless," especially when the events keep occuring despite previous reassurance or treatment.  That begs the diagnosis & treatment of the problem, and the cycle continutes.

The some very new doctors, and some very old doctors are inflexible--ones that have been in the field long enough to understand that things are variable, and ones that are open to patient input have good success.  Experience is good, but when a provider is quick to assess and dismiss, people die.

Ok, this topic's been well discussed.  Would I pick up a book on calculus if I didn't know it, or even a book on coastal erosion, sure....why not?  Let's not get our analogies out too far.....as patients, we have a vested interest in our health.

Good job everyone.
8 ^ )

[CollegeGirl143]

but could you correctly learn it? without that guiding hand to show you when you're formulas are right and when they are not?? If the answer isnt clear, how can you even begin to learn the formula?

Well Discussed post here! I always enjoy a good medical debate, especially when its done in such a civil manner.. Good job to all..

[Pepperliveson]

Every patient should be their own advocate or they are at the mercy of the healthcare system.  Learn as much as you can.

[arthur]

"Nothing in life is to be feared.  It is only to be understood." Marie Curie

Unless we know enough about an issue, we shan't be able to ask the doctor a probing question, not shall we be able to understand the answer.  We shall indeed step back into the world of the witch doctor and subjects taboo.

ECGs are really very simple.  To understand the basics is not difficult.  To understand the nuances, that's a different story...even computer algorithms are too simple-minded to do a good job of that.  I think the learned patient gets that.

There are folks in this forum that constantly tell us to avoid trying to learn the hows and whys of a thing, fearing such knowledge be misunderstood, misinterpreted, and misused.  Apparently they fear that we are likely to think we know enough about medicine to practice on ourselves and others.  Very liberal thinking, that.  Almost like a parent admonishing a child.

Alas, the conundrum... stay simple-minded and rely on pure trust, or become smart and ask the right questions.  

-Arthur