An EKG could show low voltage if the electrical leads or connections were weak, or the person being tested has a big body habitus with the heart being further away from the chest wall than a normal person.
A change in ST could mean many things, but typically it means some type of abnormal heart condtion, sometimes acute injury, like in a heart attack, or old injury, or irritation of the heart muscle. It has to be interpreted with the clinical situation.
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