Best EKG textbook?

[Guest Unknown </username> <dateline>1118448240</dateline> <title>Unknown</title> <pagetext>(This]

Ian Wong

 

Rapid Interpretation of EKG's, 5th Ed. Dubin, D. 1998. Cover Publishing. Tampa, Florida.

ISBN: 0-912912-02-2

Chapters/Indigo.ca price: $51.50

Pages: 342

 

This is a very useful textbook that most medical students recognise on sight. Perhaps this has something to do with the fact that this modest-sized paperback is bound in a fluorescent Day-Glo orange cover. This might also be due to the fact that this book has universal notoriety among clinicians, at least in my experience. Dubin's EKG book has been published since 1970, which is long enough to entrench it deeply into this current generation of doctors. I've been recommended to read and learn this textbook's contents by several different physicians throughout Vancouver's teaching hospitals. Why? Well, the book has a very simplistic outline and is put together in such a way that you can skim the entire textbook in a few days or less.

 

The book follows a very standard format throughout all of its pages. On the top half of each page, there is a either a black and white line diagram or an EKG tracing. The bottom half of that page is text describing the information that you need to understand from the corresponding diagram or tracing. Throughout each chapter, there are fill-in the blank sentences that will test you on the material you have just read. These test questions help you realise whether you have actually taken in and absorbed the material, or whether you have fallen into the glazed-eyes zone where the information leaves your brain as quickly as it enters. I've actually seen the 6th edition at the bookstore this summer, but it seems as though the major change in the book was to add colour to all the diagrams. Functionally, I don't think that matters a great deal, as the content of the book remains essentially the same.

 

The book systematically takes you through the relevant cardiac physiology before introducing the concepts of reading an EKG. Only after you have been taught the conduction pathways of the heart will you be shown how the EKG machine operates and how the EKG tracing correlates to the heart conduction. On a quick skim through just now, I'd estimate that the first third of the book deals with cardiac and EKG physiology, and the remainder to different wave-forms encountered when reading EKG's. At the back of the book, there is an appendix cheat-sheet with a step-wise approach to reading EKG's and samples of various arrythmias and wave shapes that are characteristic for different diseases. This book covers only the diagnosis of heart diseases and doesn't discuss their pharmacologic treatment or other management strategies.

 

A few potential negatives to this book besides the lack of pharmacology are the occasional repetitive statements in this book as well as the lack of good practice EKG's. As you read through this book, you'll discover that many concepts are discussed repeatedly, often in adjacent chapters. This is good for checking that you've actually absorbed the material you are reading, but after a while, it can become aggravating, as it seems like you are slogging through a chapter without learning much new information. As far as practice questions are concerned, I think it's impossible to gauge your EKG prowess without testing yourself on several EKG's. There are only seven practice EKG's in the back of the book, which is no-where near enough to test all the concepts that are explored in this textbook. For this reason, I'd recommend looking into your local medical bookstore for EKG problem books that contain nothing but sample EKG's, and answers to them on the reverse page, along with a strategy to arriving at the correct solution.

 

This is a great book that will be useful during your cardiac block, but will become indispensable during your third year clerkships where you will need to gain mastery of many diagnostic tools in a short amount of time. Dubin EKG is a book that will give you a strong base and a good systematic approach from which to learn more complex EKG patterns. The ability to read EKG's isn't too important in either Med 1 or Med 2, but it will surface repeatedly in many of your clerkships, most notably Emergency Medicine, Anesthesia, Surgery, and Internal Medicine. You'll also probably see it frequently while managing patients in your Surgery rotation. For this reason, I really recommend getting a copy of this text. It will be helpful during your Cardiovascular block, and become more valuable during your clerkships. After you've used this book for some time, it might be worth checking for other books that supply many sample EKG's to practise your new diagnostic skills.

[Guest Praeludium]

The best thing about this book is probably that it's written at a grade two level -- it is ridiculously easy to read, with full colored pictures (6th ed) and fill in the blank sentences to reinforce concepts.

 

However, if you're serious about reading EKGs and don't want to flip through 150 pages only to realize that you've only learned how to read two things on an EKG, then opt for another book such as 12-Lead ECG: The Art of Interpretation, by Garcia. (See review)

[Guest phantom8]

The best part of the Dubin EKG textbook is his "review" section at the end of the book that he actually TELLS you to photocopy. I must confess that I found reading Dubin a little tedious, but I did anyway since it was the recommended EKG book. However, I think that most of what Dubin said is all summarized in the review section, so if you need to get a quick idea as to what Dubin's about, that might be a good place to start.

[Guest Unknown </username> <dateline>1118448240</dateline> <title>Unknown</title> <pagetext>(This]

12-Lead ECG: The Art of Interpretation, Garcia, Tomas and Holtz, Neil. 2001. Jones and Bartlett Publishers.

ISBN: 0-7637-1284-1

Chapters/Indigo.ca price: $51.95

Pages: 536

 

The recommended introductory textbook for learning about EKGs is probably Dubin's Rapid Interpretation of EKG's (the bright fluorescent orange one). Garcia probably falls a distant second down the list. This review is biased in that the author strongly prefers Garcia over Dubin.

 

The good thing about Dubin is that it is ridiculously easy to read. The latest (6th) edition is chock full colored pictures and fill in the blank sentences to reinforce concepts. Dubin can be read from cover to cover in about 4-5 hours, providing a good foundation for the theory and history behind EKG's.

 

The problem is that in order to become proficient at reading EKG's, one must practice, practice, practice. Dubin will show a strip or two of EKG that demonstrates, say, atrial enlargement, but this is in no way adequate for a student to recognize the same manifestation outside of that single example. If the multiple choice exam is going to be a photocopied page of a idealized EKG from Dublin, then by all means, get Dublin, but if you wanted a solid foundation on how to read EKGs and a book that will last you past 1st year medicine, then I strongly suggest taking a look at Garcia.

 

The book is unique in that each of its pages are tagged with a level marker from 1 to 3. Level 1 gives the reader the most basic of all information (the theory). Level 2 expands concepts further incorporating over 200 full-sized real life sample EKGs with an interpretation. Finally, level 3 covers more sophisticated concepts in the EKGs that one might recognize as advanced practitioners. In contrast to Dubin's unorthodox literary style, Garcia is written in a more or less high-yield textbook manner.

 

The strength of this book lies in its numerous samples of practice EKGs. For every one concept, Garcia reinforces it by providing several EKGs showing the same thing so that as a student, I can pick out the anomaly from the background noise. I start to recognize the variations that a certain pathology might manifest. Whereas Dublin might give a couple example of right bundle branch block (RBBB), Garcia gives me over TEN. That way, I start looking at patterns rather than a sinlge specific shape, and that is what EKG interpretation is about.

 

Another thing that I like about the book is that I can go through the EKGs sequentially with each successive example building on things that I have learned previously. Garcia guides you through interpreting EKGs -- it is an easy read. Through the many practice EKGs, it is automatic that one naturally develops a systematic way to analyze EKGs, yielding a thourough and comprehensive interpretation of the EKG. Garcia reinforces past concepts by frequently prompting and reminding the student to look for topics covered previously.

 

Garcia's book is very well organized and indexed. Every abnormality on an EKG can be found from the index. The chapters progress systematically from the P-wave to the ST segment and T-wave, to myocardial infarctions. With Dubin, I'm not exactly sure how it is organized, why certain pathologies are placed before others.

 

If Dubin is the recommended textbook, then Garcia does lack some information about the history of EKGs and some specifics on its theory. In this case, I would suggest getting Garcia and skimming Dubin (it will take 15 minutes at most) to pick up on the one or two points that were not covered in Garcia.

 

This book does have full-colored illustrations with excellent diagrams detailing the concepts behind the EKGs and what they represent, superior in quality to those of Dubin's. Dubin really falls short on examples and this is what is crucial in terms of understanding EKGs. Garcia provides tons of EKGs for you to peruse over while you'd be hard pressed to appreciate EKG nuances with Dubin. Dublin is written and organized at a grade two comprehension level which can make it seem like a waste of time reading it. For better yield in less time, Garcia is the way to go.

 

The bottom line is that if you want to just pass the test in your first year or plan on doing something like psychiatry where you'll never see EKGs again, then go for Dubin. But if you really want to show off your EKG skills in the ER, then Garcia beats Dubin hands down. In my opinion, for the same price, you get a much better book.