Absolute Small Voltage

Report:

Supraventricular tachycardia, possibly sinus, 146/min

Absolute small voltage

QRS < 5 mm frontal, < 10 mm chest leads

Diffuse ST segment depression c/c infarction/ischæmia

Comment:

Some of the best examples of “ischæmic” ST segment depression come from hypoxic patients like this one. She arrested twice in profound hypoxæmia from ARDS, but made a surprisingly good recovery. Youth helps.

Small voltage attends fluid accumulation from any cause57, including, as in this case, multi-trauma and sepsis from ruptured ileum.

Below (Fig 80a) is a later trace, without hypoxæmia: still in small voltage, but otherwise normal, or at least appropriate, with a rate of 112/min.

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