Difference between revisions of "Low ECG voltage"

(Added algorithm, more detailed differential diagnosis)
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==Definition==
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==Definition<ref>Madias JE. Low QRS voltage and its causes. J Electrocardiol. 2008;41(6):498–500. doi:10.1016/j.jelectrocard.2008.06.021</ref>==
*QRS < 5 mm in limb leads, or
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*QRS < 5 mm in limb leads
 
*QRS < 10 mm in chest leads
 
*QRS < 10 mm in chest leads
  
==Causes==
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==General Causes==
*Low electrical power within the heart (e.g. hypothyroidism)
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*Fluid, fat or air attenuating signal
*Poor electrical conduction within the heart (e.g. sarcoid or scar tissue)
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*Myocardial infiltration
*Poor conduction of signal from the heart to the ECG lead (e.g. obesity, COPD, pericardial effusion)
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*Loss of viable myocardium
**Low voltage + tachycardia = pericardial effusion until proven otherwise
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 +
==Differential Diagnosis==
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[[File:Low_Voltage_ECG.png|thumb|Specific causes of low voltage ECG]]
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=== Cardiac ===
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*Post-MI
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*Infiltrative cardiomyopathy
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*Myocarditis
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*Hypothyroidism
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=== Pericardial ===
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*Effusion
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*Constrictive pericarditis
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*Pneumopericardium
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=== Extracardiac ===
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*COPD (limb leads)
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*Pneumomediastinum
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*Pneumothorax
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*Pleural effusion
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*Pulmonary edema
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*Peripheral edema
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*Obesity
  
 
==See Also==
 
==See Also==

Revision as of 22:08, 26 January 2016

Definition[1]

  • QRS < 5 mm in limb leads
  • QRS < 10 mm in chest leads

General Causes

  • Fluid, fat or air attenuating signal
  • Myocardial infiltration
  • Loss of viable myocardium

Differential Diagnosis

Specific causes of low voltage ECG

Cardiac

  • Post-MI
  • Infiltrative cardiomyopathy
  • Myocarditis
  • Hypothyroidism

Pericardial

  • Effusion
  • Constrictive pericarditis
  • Pneumopericardium

Extracardiac

  • COPD (limb leads)
  • Pneumomediastinum
  • Pneumothorax
  • Pleural effusion
  • Pulmonary edema
  • Peripheral edema
  • Obesity

See Also

References

  1. Madias JE. Low QRS voltage and its causes. J Electrocardiol. 2008;41(6):498–500. doi:10.1016/j.jelectrocard.2008.06.021