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Low Voltage Limb Leads

I am a healthy asymptomatic 46 y/o female who had a routine ECG done at a normal health visit.  I have a medical background.

My limb leads are uniformly small--with voltages of 2-3 mm throughout, and AVL barely moves.  The morphology of the ECG, however, is entirely normal.  V1-V6 show good R-wave progression, and no abnormalities, with normal QRS voltages ranging from about 10 mm to 18 mm in V2 (the strongest lead).

I'm scheduled for an Echo and suspect that an effusion needs to be ruled out.  My question is:  how common are low voltage QRS in just the limb leads-- how likely is it that this is just "me?" versus an effusion.

Second question, since this is the interventional cardiology forum, if an effusion is diagnosed (and if labs, X-ray, reveal no concerns)....do you generally become invasive or can you treat and follow (with Motrin/diuretic, etc).  How common are "idiopathic" effusions?

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290386 tn?1193630481
It is uncommon to have low voltage only in limb leads if you have significant pericardial effusion. The echo will help answer that question and will also provide information about possible need for intervention (to remove the fluid) if it interferes with the working of the heart
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