The electrocardiogram in obesity

The electrocardiographic abnormalities ascribed to morbid obesity were analyzed in a group of 144 patients without apparent clinical cardiovascular pathology and compared with a control group of 100 normal weight patients. Fifty-eight patients in the obese group were re-analyzed after significant weight loss and the electrocardiographic findings compared with their initial changes when they entered the program. The QRS voltage for the obese group was slightly lower than the voltage of the normal population; but in a significant number of the patients restudied after weight loss, the QRS voltage decreased (37 out of 58 patients). In inferolateral leads non specific flattening of the T wave was observed in the obese group (71/144); it became normal as they lost weight. The P and QRS axes of the obese group initially were within normal limits but more to the left; they moved slightly to the right, although still within normal limits as the patients lost weight. Two conclusions can be drawn from the study: a) low voltage is not a significant feature in the ECG of the obese and, b) the most consistent finding in obese patients is a flattening of the T wave.