Slide 1: What’s the EKG finding? [EKG]

Slide 2: Low voltage! [EKG showing avg amplitude < 5mm in the limb leads AND avg amplitude < 10mm in the precordial leads.]

Slide 3: DDx: anything that can get between the heart and the EKG leads! [diagram showing ddx: pleural effusion, pneumothorax, COPD, obesity, pericardial effusion, infiltrative cardiomyopathy, end stage heart failure]

Slide 4: Bonus pearl! Low voltage on EKG but LVH on TTE? Think possible amyloid! Beta pleated sheets in the myocardium -> LVH, also -> myocardial death -> low voltage

References

  • Madias JE. Low QRS voltage and its causes. J Electrocardiol. 2008 Nov-Dec;41(6):498-500. Epub 2008 Sep 19. PMID 18804788

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