Is another book on the electrocardiogram (ECG) really necessary if there are already so many? One could venture a literary answer, stating that those who know Anna Karenina should not ignore Madame Bovary. We do not know and will never cease to talk about the heart enough, the heart that follows the rules and the heart that is forced to betray them because of congenital or acquired reasons, because of hemodynamic or electrical reasons. More prosaically, one can add that among the many published texts, only a few are dedicated to children and the young.

Ferdinand Céline was a French physician who became a famous writer. He said that adults are children gone bad. So even the doctor with little or no specialization in pediatrics eventually feels the need to know what the patient’s ECG was like before the deterioration. In “The Metamorphosis ” by Franz Kafka, Gregor Samsa becomes an insect and dies unrecognized even by his family. Culture and science, on the other hand, should serve to discover the man hiding in an insect.

There are mathematical explanations dating back to Descartes that put the P at the beginning of the ECG glossary, and not the A as would be more intuitive [1]. However, if the smallest wave, the one that first comes out of the heart and breaks through the skin to land on the pink paper, is called P, there must be other reasons. Many childhood heroes begin with P: “Le Petit Prince (The Little Prince),” to tell us that what is essential is invisible to the eye and can only be seen with the heart. “Pinocchio,” to remind us that the ECG is sincere but does not always tell the truth. “Peter Pan,” with his desire never to grow up, just like the P wave. Le Petit Poucet or Pollicino (Tom Thumb), the cunning P, able to disguise and hide. The Dickensian Philip Pirrip “Pip” of “Great Expectations.” “Pippi Longstocking” by Astrid Lindgren, herself an orphan, an example of power to the imagination. The “Pink Panther” of seraphic guile. Schulz’s cartoon strip “Peanuts,” with the gang including the dynamic “Peppermint Patty.” Not to mention Walt Disney’s “humanized” dog Pluto, an example of candor and levity. Then we have the dreamy Pimpa, with its four paws firmly planted in the clouds. Finally, a sign of the times is the very current “Peppa Pig,” which sums up the ECG with porky pragmatism. In fact, pork is pink and cheap and can be used up to the very last bit. In German culture there is the “Eierlegende Wollmilchsau,” a mythic pig that lays eggs like a chicken, gives milk like a cow, wool like a sheep, and ends up in ham and chops, practically like an ECG, which sometimes acts as an echocardiogram, a catheterization, and an MRI all in one.

On an ECG and on the palm of a hand, the body of a beat can be dissected into three parts like a beetle (from the Greek “en temnein,” cut into pieces) (Table 1.1, Fig. 1.1), namely, the head, the P wave and PR segment, where everything starts; the chest, the QRS complex, where everything moves; and the abdomen, the ST-T segment, restoring ionic balance and where everything returns to baseline status. We start off on our campaign with a butterfly net of graph paper to capture the enchanting winged creature and study it; the subjects of our research could be at different stages of development. In insect metamorphosis there are four stages: egg, larva, pupa, adult insect (the latter also called imago, or imagine). The ECG is the only image, the only visible phase of the electrical activity of the heart. More precisely, we can recognize four ECG stages: neonatal age up to 1 month, early infancy up to 3 years, second and third periods of infancy up to 12 years, and adolescence and adulthood after the age of 12 years.