Premature ventricular contraction: Difference between revisions
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*[[Alkalosis]] | *[[Alkalosis]] | ||
*[[Hypoxia]] | *[[Hypoxia]] | ||
*[[Myocardial infarction]] | |||
*[[Cardiomyopathy]] | |||
*Drugs | *Drugs | ||
[[File:PVC10.jpg|thumb|PVC]] | [[File:PVC10.jpg|thumb|PVC]] | ||
[[File:PVC 1.png|thumb|PVCs]] | [[File:PVC 1.png|thumb|PVCs]] | ||
==Clinical Features== | |||
*May be asymptomatic, or may have [[Palpitations]] | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Palpitations DDX}} | {{Palpitations DDX}} | ||
==Workup== | ==Evaluation== | ||
===Workup=== | |||
*[[ECG]] | |||
*If PVC burden is large, consider: | |||
**TSH | |||
**BMP | |||
**Magnesium level | |||
**Ionized calcium | |||
==Management== | ==Management<ref>Keany et al. Premature Ventricular Contraction Treatment & Management. Updated Jan 7, 2014. http://emedicine.medscape.com/article/761148-treatment#d10</ref>== | ||
*Benign; generally does not require any treatment or additional workup | |||
*Treat [[hypoxia]]/[[drug overdose|drug toxicity]] if existing | |||
*Correct [[electrolyte imbalances]], particularly magnesium, calcium, potassium | |||
*Acute [[MI|ischemia/infarction]]: | |||
**Complex ectopy frequently seen after patient receives thrombolytics | |||
**1st line are [[beta-blockers|β-blockers]], options below<ref>McAuley DF. Beta Blockers. GlobalRPH. http://www.globalrph.com/beta.htm</ref>: | |||
***Acute MI: [[Metoprolol]] 5mg IV q2 min for x3 doses, then PO metoprolol 50mg q6hrs for 2 days, followed by maintenance of 100mg bid | |||
***Post-MI: [[Atenolol]] 5mg IV over 5 min, then repeat in 10 min, then PO atenolol 50mg q12hrs for 7 days post-MI | |||
==Disposition== | ==Disposition== | ||
*Generally may be discharged (unless other indications for admission exist) | |||
==See Also== | ==See Also== | ||
*[[ECG (Main)]] | |||
==External Links== | ==External Links== | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category: | [[Category:Cardiology]] | ||
Latest revision as of 17:07, 25 September 2019
Background
- Abbreviation: PVC
Causes
Clinical Features
- May be asymptomatic, or may have Palpitations
Differential Diagnosis
Palpitations
- Arrhythmias:
- Non-arrhythmic cardiac causes:
- Psychiatric causes:
- Drugs and Medications:
- Alcohol
- Caffeine
- Drugs of abuse (e.g. cocaine)
- Medications (e.g. digoxin, theophylline)
- Tobacco
- Misc
Evaluation
Workup
- ECG
- If PVC burden is large, consider:
- TSH
- BMP
- Magnesium level
- Ionized calcium
Management[1]
- Benign; generally does not require any treatment or additional workup
- Treat hypoxia/drug toxicity if existing
- Correct electrolyte imbalances, particularly magnesium, calcium, potassium
- Acute ischemia/infarction:
- Complex ectopy frequently seen after patient receives thrombolytics
- 1st line are β-blockers, options below[2]:
- Acute MI: Metoprolol 5mg IV q2 min for x3 doses, then PO metoprolol 50mg q6hrs for 2 days, followed by maintenance of 100mg bid
- Post-MI: Atenolol 5mg IV over 5 min, then repeat in 10 min, then PO atenolol 50mg q12hrs for 7 days post-MI
Disposition
- Generally may be discharged (unless other indications for admission exist)
See Also
External Links
References
- ↑ Keany et al. Premature Ventricular Contraction Treatment & Management. Updated Jan 7, 2014. http://emedicine.medscape.com/article/761148-treatment#d10
- ↑ McAuley DF. Beta Blockers. GlobalRPH. http://www.globalrph.com/beta.htm