Wednesday, November 7, 2018

10th Anniversary of Dr. Smith's ECG Blog: First Post was November 7, 2008

This was the first post 10 years ago today:

ST depression: is it ischemia? No, hypokalemia.

A bit of history:

K. Wang formerly sent out a paper ECG through interoffice mail called "The EKG of the Week."  When he left Hennepin to go to the University of Minnesota, I decided to start sending out the "EKG of the Week" by email to any residents and faculty in our department who wanted it.  Scott Joing, the founder of our department educational site suggested that it would be easier just to blog it and send out the link to the blog. 

It sounded like a good idea.  He set it up and called it "Dr. Smith's ECG Blog."  I am not much of a techie myself, so would not have thought of it. 

Soon after, I noticed that there were viewers from outside Hennepin, there were comments, and the numbers went up.  This was a complete surprise, and totally unplanned.  

By December 2010, Scott Weingart gave the blog high marks on EmCrit, and viewership exploded, so that by May 2011, there were about 30,000 pageviews per day.

Viewership really exploded with the use of Facebook.  Now whenever I post, I promote on FB and get at least 20,000 views there, and up to 85,000, and most of the traffic to the blog comes from FB.  I also promote on Twitter, but get far less traffic from there.

There are now 945 published posts.  I have 249 drafts in various stages of writing, many (if not most) abandoned because I just can't get them into a form which has a distinct message.

There are over 13,000,000 pageviews on the blog now.  There were 40,000,000 views on Google image search when they stopped counting 2 years ago.  There are 55,000 Facebook followers and 14,000 on Twitter.  I never expected any of this!

Why did the blog catch on? What made it different from the multitude of other ECG sites or textbooks?

I believe there are several factors:

1. It is free FOAMed.
2. It is always in clinical context: how does this ECG help to manage this patient?
3. I have developed unique ways of diagnosing ischemia and acute coronary occlusion which were, and still are, not well known, and I can illustrate these here on the blog.
4. Every ECG finding has many different manifestations, and this wide variety can be displayed online.  Every de Winter's T-wave looks different.  Every subtle occlusion looks different.  These many morphologies could only be displayed online, never in a book, as there is not enough space in a book.  
5. Similarly, ECGs are dynamic; they evolve.  Books show only one, or sometimes 2 sequential ECGs.  I can post a half dozen or more to show this evolution.

Now Pendell Meyers and Ken Grauer are adding a lot of insight to the blog.

We are going to keep it going!  Thanks for reading!!

Steve Smith


  1. My most heartfelt CONGRATULATIONS to Dr. Stephen Smith on the 10th Anniversary of his ECG Blog. I instantly recognized the unique educational value and amazing clinical insights on ECG interpretation in an Emergency setting provided by his Blog, that in my opinion outshines all other ECG forums. I therefore jumped at Steve’s invitation to me earlier this year to become an Associate Editor. It’s a treat to be part of Steve’s vision that has truly transformed the art of emergency medicine electrocardiography. THANK YOU Steve!

    1. Ken,
      thanks for your invaluable contributions!!
      You are the true expert and add so much.

  2. Congratulations Dr.Smith.
    Your Blog is an invaluable source of information which no textbook can match. We deeply appreciate your time and hard work that you devote to this blog.

  3. Awesome, great job.
    CONGRATULATIONS to Dr. Stephen Smith on the 10th Anniversary of his ECG Blog.
    In the last year, your blog has several hundreds of readers from Russia, and their number is constantly growing.
    Many years ago, Dr. Smith's blog became a real discovery for me and really changed my life. THANK YOU Steve!

  4. you guys are incredible. you have helped me immensely, and i believe you have helped my patients.
    you certainly have changed my way of thinking, my practice, my focus on the ECG. the ecg placed in front of my face , maybe 10 an hour from triage, has gone from an "interruption" to a picture of beauty. when i happen to pass through the ER on my days off (much to the frustration of my ER family), i can't help but look at any ECG lying around.
    thank you steve, ken and pendell.


    1. Thanks Tom. Glad to hear someone besides me being stopped in their tracks when a BEAUTIFUL ECG passes by ... — :)

  5. Thank you for your constant effort.

  6. Congratulations Dr. Smith . Thank you for teaching me so much! Ciao. Vittorio

  7. Congratulations sir,,
    We benefitted much

  8. Congratulations Dr. Smith for the 10th anniversary of your ECG blog!
    After having discovered your blog some years go I became a better cardiologist; your blog it's a truly gold mine.
    Thnak you so much for your teaching!

  9. Congratulations on this wonderful educational resource. Im sure you have indirectly saved many many lives as a result. Thank you, and hope it keeps going for many more years!

  10. Congratulations Dr. Smith.
    I have learned much from your blog.
    Thank you so much.
    Best wishes from Vietnam.


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