<s>[INST] I was in hospital the other night and they ran EKG on me my tropoline level was 0.02 but my EKG one said borderline low voltage frontal lead and the other said borderline low voltage extremitys and I am still having very bad chest pains around my sternum and under my left chest muscle [/INST] Dear patient unfortunately one has to be able to look at the ECG to give the full diagnosis. However, 2 of the reasons of low voltage in the ECG can be 1) Pericardial effusion/Pericarditis : Fluid fills up in the sac around the heart and can cause pain while breathing. Get a 2d echo done to diagnose it.2) Pleural effusion: The pain is sharp and is present on both inspiration and expiration. A chest x-ray can help diagnose it3) Persistent angina: Tightness around your chest can be angina in which case the treatment aspirin 75 mg once a Dante tablet sublingual stat for pain on SOS basisCalcium channel blockers after discussion with your doctor </s>