A patient with ascites may show certain changes in the electrocardiogram.


Changes in the ECG that may occur with ascites:

(1) low amplitudes in precordial leads

(2) low amplitude in limb leads

(3) moving the precordial leads cranially increases the voltage (usually moving this causes the voltage to decrease)

(4) paracentesis with removal of ascites fluid normalizes the percordial leads but not the limb leads


Factors that may contribute:

(1) peripheral edema

(2) electrolyte abnormalities

(3) increased intra-abdominal pressure, which may affect cardiac and renal function

(4) raising of the diaphragm with displacement of the heart cranially


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