Low ECG voltage

Background

General Causes

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

Clinical Features

Differential Diagnosis

Specific causes of low voltage ECG
Sample 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

Diagnosis

  • ECG[1]
    • QRS < 5 mm in limb leads
    • QRS < 10 mm in chest leads

Management

  • Treat underlying condition

Disposition

  • Depends on underlying condition

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