This text is an incredibly useful reference appropriate for students, nurses, and physicians at all levels of training or expertise. I skimmed the book while in residency and have reviewed it much more thoroughly since completing my training.

The utility of this reference is basically three-fold...

In the acute setting, it is perhaps the only reference that provides more than 200 case-based examples of both 'classic' and more subtle ECG findings to assist in ECG interpretation. High-yield and 'do not miss' facts and examples of both normal and abnormal findings secondary to ischemia or structural abnormalities are highlighted for quick reference. I have not found a more useful resource that can so quickly provide such valuable information.

The text also includes concise review of basic principles imperative to understanding (not just memorizing) ECG interpretation including brief reviews of anatomy, vector analysis, structural defects, and how these factors affect ECG findings. It also illustrates the dynamic nature of the ECG in the setting of ischemia by showing serial ECGs and ECG findings at varying stages of myocardial injury and recovery.

Included in each chapter is an annotated bibliography which acts as a very helpful guide to recent literature. This provides a more focused summary of relavent studies related to each chapter, which allows you to select those suitable for more in-depth review.


The only negative feedback I've heard from friends/colleagues is mild discontent with the rather 'bulleted' text presentation. Personally, I find this to be a strength of the reference as it facilitates rapid review without sacrificing content.

The bottom line is that this text is high-yield, absolutely worth $50, and is the only resource I've found that is focuses on utility in the urgent/emergent setting. I've bought many books, but I actually use this book.

Reviewer:  Scott Joing

This is a very comprehensive, evidence-based book which will improve your ability to interpret what that ECG is telling you about your patient. I particularly like the extensive use of actual patient cases. Definitely worth the $50.

Reviewer: Gary Josephsen

This book is a great tool to bring your interpretation of ECG in the setting of MI to the next level. If you are a medical student who wants to become competent at reading ECGs you need this book. It not only serves as a tutor, but also as a reference. It's so packed with relevant information that I can't imagine how other medical students can go without it, especially anyone considering a career in Emergency Medicine. If you understand the addage: "the more you know the more you learn," then you'll understand exactly why you need this book early in your career. This book will make you a better doctor.
 

Reviewer:  Lynne McCullough, MD FACEP (Los Angeles, CA)

The ECG in Acute MI provides a quick reference text for use in critical clinical situations in which accurate ECG interpretation will lead to more rapid recognition of appropriate candidates for reperfusion therapy, as well as a text for more detailed study of electrocardiogram interpretation. This manual is intended for all clinicians that may have to recognize and treat an acute myocardial infarction (AMI). Thus, this book is for emergency department physicians, cardiologists, critical care physicians, hospitalists, internists, family practitioners, physician assistants, cardiac care nurses, residents and medical students. The text assumes a basic clinical understanding of electrocardiograms and common terminology, and focuses on outlining the essentials of ECG interpretation and how they may be used to accurately diagnose AMI, as well as to facilitate appropriate and timely reperfusion therapy. In this manual, reperfusion therapy includes the use of thrombolytics and percutaneous coronary intervention (PCI), including angioplasty and stent placement. The authors utilize a well-organized format of concisely written text with key points highlighted and numerous clinical and electrocardiographic demonstrations included in every chapter in order to illustrate core concepts, and allow for quick reference. The text is divided into six sections for rapid review and easy access: General Issues of ECG Morphologies and the Diagnosis of AMI; the ECG Morphologies of AMI broken down by anatomic distribution (i.e. anterior MI, Inferior MI, etc.); Conditions that can obscure the diagnosis of AMI, including ECG pseudo-infarction patterns and AMI look-alikes; Other issues including atypical presentations, biomarkers and echocardiography as used in the reperfusion decision; and the management of AMI.

The ECG in Acute MI includes more than 300 12-lead ECGs, over 200 of which have accompanying case histories to help the reader understand the ECG in a clinical context. Many of the case examples include angiographic findings that serve to cement the reader's understanding of the ECG manifestations of anatomical disease. The chapters and representative example cases are cross-referenced extraordinarily well, facilitating review and comparison in an emergency setting. In addition, each chapter contains an extensive annotated bibliography outlining the pertinent studies previously published, including interpreted methods, findings and comments. The value of including a detailed description of the evidence based literature on which assertions in the text are made, cannot be overstated. Overall, there are more than 500 cited references for the text.
The ECG in Acute MI is well organized, thorough and an easy to use manual, both for the seasoned physician and the clinician in training. Although a manual focusing only on ECG interpretation seems a bit daunting at over 300 pages, the concise format of the text makes reading or reviewing chapters either to refresh prior knowledge or verify findings of an acute ECG in the clinical setting to confirm an interpretation entirely possible. While the reviewer had been comfortable with her ability to interpret ECG's in the acute setting, she was pleasantly surprised at just how much she learned from this manual. The authors set out to review and highlight the key aspects of ECG interpretation in order to more accurately diagnose acute MI and facilitate appropriate and timely therapy. The authors focus on educating the reader on the more sophisticated interpretation of subtle, non-diagnostic and atypical electrocardiographic findings of infarction, beyond the much more easily recognized "tombstoning" pattern of AMI. Additionally, the case based discussion utilizing serial ECG's emphasizes the dynamic nature of the electrocardiogram in acute myocardial infarction. This has led the reviewer to be much more suspicious of subtle hints on an initial ECG and the value of repeated examination in the acute clinical setting. The drawback of a text focused on subtle and atypical ECG findings is that the manual is occasionally tedious in its' detail and tiresome in its' description of differentiating characteristics of subtleties.