There are multiple causes of low QRS voltage on the ECG, and often it is unexplained and considered to be a normal variant [1], occurring in 1.4% of individuals free of cardiovascular disease [2]. Although recently low QRS voltage has been shown to be associated with increased mortality in the general population [2], as far as we know a relationship between low QRS voltage and the in-hospital mortality of acutely ill patients has never been reported. Recently a good correlation has been reported between weight loss in patients with heart failure and the combined amplitudes of the QRS complexes of ECG lead I and II [3].