If the left ventricular high voltage is a physiological variant, it will not cause chest tightness and shortness of breath; if the left ventricular high voltage is a pathologic manifestation of heart disease, there may be symptoms of chest tightness and shortness of breath, and there is no direct causal relationship between the two. Left ventricular high voltage, one of the results of electrocardiography, is only an electrocardiographic manifestation, not the cause of the disease; chest tightness and shortness of breath is a clinical symptom, and there is no causal relationship between left ventricular high voltage. 1. Physiological left ventricular high voltage: if only the left ventricular high voltage appears in the electrocardiogram, the ultrasound and CT examination do not show any abnormality, and the patient does not have obvious self-conscious discomfort symptoms, it may be a physiological variant. This situation is mostly seen in normal men with thin body size, due to the thin chest wall, resulting in the phenomenon of high voltage in the left ventricle during ECG examination. 2. Pathological left ventricular high voltage: hypertensive heart disease, hypertrophic cardiomyopathy, heart valve disease and other diseases, affecting the diastolic function of the heart myocardium, left ventricular high voltage phenomenon will also occur. At this time, echocardiography, chest CT and other examinations can be found to have obvious abnormalities. At this time, the patient may experience symptoms such as chest tightness, panic, shortness of breath, cardiac distress, cough, edema, etc., or there may be no chest tightness and shortness of breath, but cough, edema, cardiac distress, etc. In conclusion, when the ECG examination reveals the presence of high voltage in the left ventricle, it is necessary to seek medical treatment in time, and the doctor will make a comprehensive analysis and judgment based on the patient’s symptoms, medical history, and the results of other examinations, and then formulate a treatment plan for treatment.