Premature ventricular contraction

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Background

  • Abbreviation: PVC

Causes

PVC
PVCs

Clinical Features

Differential Diagnosis

Palpitations

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

  1. Keany et al. Premature Ventricular Contraction Treatment & Management. Updated Jan 7, 2014. http://emedicine.medscape.com/article/761148-treatment#d10
  2. McAuley DF. Beta Blockers. GlobalRPH. http://www.globalrph.com/beta.htm