I have gone through your ECG. The main finding I see is low voltage QRS complexes. This means the electrical signals picked up from the heart are smaller than usual. It describes the tracing and is not a diagnosis by itself. Low voltage has several possible causes. Some lie outside the heart, such as extra tissue between the heart and the chest leads, lung conditions like emphysema, or an underactive thyroid. Some relate to the heart itself. The most important of these is fluid collecting around the heart (pericardial effusion), and less commonly, changes in the heart muscle. Lead placement and machine settings can also produce it. About the words "ischemic ST changes" on your report. That line is usually printed by the ECG machine's automatic software, and these automatic readings often over-call minor ST and T wave changes, particularly in women. It is not proof of a blocked artery. A cardiologist has to read the tracing along with your symptoms. The reason the ECG was done also matters a great deal. If it was done to evaluate chest pain, please know that a resting ECG can be misleadingly normal in some patients. It records only a few seconds of the heart at rest, and many people with significant narrowing of the heart arteries have a normal or near normal ECG when they are not having pain. So in someone with chest pain, an ECG alone cannot rule out heart disease.