Premature ventricular contraction: Difference between revisions
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==Management<ref>Keany et al. Premature Ventricular Contraction Treatment & Management. Updated Jan 7, 2014. http://emedicine.medscape.com/article/761148-treatment#d10</ref>== | ==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 | *Benign; generally does not require any treatment or additional workup | ||
*Treat hypoxia/drug toxicity if existing | *Treat [[hypoxia]]/[[drug overdose|drug toxicity]] if existing | ||
*Correct electrolyte imbalances, particularly magnesium, calcium, potassium | *Correct [[electrolyte imbalances]], particularly magnesium, calcium, potassium | ||
*Acute ischemia/infarction: | *Acute [[MI|ischemia/infarction]]: | ||
**Complex ectopy frequently seen after patient receives thrombolytics | **Complex ectopy frequently seen after patient receives thrombolytics | ||
**1st line are β-blockers, options below<ref>McAuley DF. Beta Blockers. GlobalRPH. http://www.globalrph.com/beta.htm</ref>: | **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 | ***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 | ***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== | ||
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