Echocardiography has replaced the phonocardiogram as the clinician’s diagnostic method of choice. Sophisticated radiologic procedures have relegated routine office fluoroscopy to a position of historical curiosity. However, a technique introduced 100 years ago retains vital clinical relevance. On March 22, 1905, Wilhelm Einthoven recorded the first ECG from a healthy man. Elegant machines have supplanted his simple string galvanometer, but perusal of the traditional P-QRS-T pattern is still the basis for obtaining important information in our evaluation of acute and chronic cardiac disease.