Smaller pediatric chest wall --><unk> leads closer to heart --> exagerated voltages
V2-V5 most likely to appear high voltage<unk> auto-interpretations may "over-report" left or right ventricular hypertrophy
LVH (quick/dirty method)
If R of V6 intersects with baseline of V5--> abnormal
RVH indicators
Upright T-wave in V1 after 7 days of life
If RSR' present; R' taller than R wave
Pure R wave in V1 in child >6mo
V2-V5 most likely to appear high voltage<unk> auto-interpretations may "over-report" left or right ventricular hypertrophy
If R of V6 intersects with baseline of V5--> abnormal
Upright T-wave in V1 after 7 days of life
If RSR' present; R' taller than R wave
Pure R wave in V1 in child >6mo
ECG 
Cardiac enzymes
Cardiac ultrasound
D-dimer
Transcutaneous pacing
Defibrillation
Pulmonary artery catheter
IVC ultrasound