There are multiple techniques and systems for analyzing the ECG. In the beginning it is important for the student to develop a systematic and methodical approach to ECG reading (Table 1). Eventually everyone develops a personal style, although most experienced ECG readers evaluate the ECG with an initial “glance” to determine the extent of abnormalities and determine whether any urgent problems are immediately apparent on the ECG, and then go from “big” picture to “little” picture, focusing on specific findings at the end of their evaluation.