Interpreting ECGs, My Way.....

Here is a normal ECG. I am told that despite it's first appearances, it is actually possible to translate these lines into electrical activity in the heart. Each line represent a different angle from which the heart is looked at. If you're one of the clever people then you might even notice when something is going wrong. Doctors, usually, can understand these squiggly lines.

Here is what magically happens to a fairly inconspicuous ECG when it is handed to me by a consultant and I am asked "what do you see here?"

As far as I can tell, this happens for a few reasons. Firstly, I have a nasty habit of choking under acute pressure, forgetting everything I know about everything, including when my birthday is, and how to keep my bowels closed. Secondly, it is because, after six or seven identical lectures entitled "How to understand an ECG", I still cannot understand an ECG. Thirdly, it is because the little elves in my head who turn the cogs are extremely easy to distract and would prefer to think about sarcasm, boobs, Bristol City and Jack Daniels, in no preferential order.

So, I have devised a foolproof algorithm for answering the question "what is wrong on this ECG?"

1. Pick a letter from P, Q, R, S and T. These, I am told, correspond to specific squiggly bits.
2. Pick a word from "inversion", "elongation", "elevation" and "absence". These are a few of the things that can go wrong with the aforementioned squiggly bits.
3. Pick a number from 1 to 6, or if you're feeling smug, pick aVF, aVR or aVL. These are the different lines with the squiggly bits on.
4. Report our answer, for example- "Q wave elongation in lead aVF".
5. Sit back and soak up the glory or, in the rare case of a wrong answer, say "oops, did I say aVF? I meant lead 3...".

Don't go spreading my technique around though guys, or everyone will end up being great at cardiology and I'll never get a job.