Little is known about the effect of blood pH on the electrical activity of the heart. Covino and Hegnauer1reported the effects on the cardiac cycle relative to pH changes in an experimental model. Changes in the PR interval, QTc interval and “J” waves of the electrocardiogram (ECG) have been described in the presence of both acidosis and hypothermia.2,4,6We wish to report a case in which the degree of metabolic acidosis correlated significantly with alterations in the ECG, in the absence of hypothermia and significant serum potassium or calcium abnormalities.