Premature junctional complex: Difference between revisions
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== | ==Background== | ||
[[File:WPW and PJC.JPG|thumbnail|WPW with PJC underlined in red]] | [[File:WPW and PJC.JPG|thumbnail|WPW with PJC underlined in red]] | ||
*Less common than PVCs or PACs | *Less common than PVCs or PACs | ||
*Differentiate from [[WPW]] (short PR) | *Differentiate from [[WPW]] (short PR) | ||
*May be seen in healthy individuals with no clinical significance | *May be seen in healthy individuals with no clinical significance | ||
* | **May also be seen in pathology such as [[valvular emergencies|valvular disease]], [[drug overdose|drug toxicity]], [[electrolyte abnormalities]] | ||
==Clinical Features== | |||
*Generally asymptomatic | |||
*May cause palpitations | |||
==Differential Diagnosis== | |||
{{Palpitations DDX}} | |||
==Evaluation== | |||
*EKG | |||
**P wave is either: Absent, Abnormal with PR < 120ms, '''OR''' Retrograde, which may be inverted in inferior leads | |||
**PJC arrives before next sinus beat | |||
**Followed by compensatory pause | |||
**From AV node region, with ventricular response usually normal, so QRS complexes usually narrow | |||
**If conduction is abnormal, may have right bundle branch block morphology | |||
==Management== | |||
*Depends on etiology and symptoms | |||
==Disposition== | |||
*Based on etiology and symptoms | |||
==See Also== | ==See Also== | ||
*[[ECG (Main)]] | *[[ECG (Main)]] | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
Latest revision as of 06:07, 29 September 2019
Background
- Less common than PVCs or PACs
- Differentiate from WPW (short PR)
- May be seen in healthy individuals with no clinical significance
- May also be seen in pathology such as valvular disease, drug toxicity, electrolyte abnormalities
Clinical Features
- Generally asymptomatic
- May cause 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
- EKG
- P wave is either: Absent, Abnormal with PR < 120ms, OR Retrograde, which may be inverted in inferior leads
- PJC arrives before next sinus beat
- Followed by compensatory pause
- From AV node region, with ventricular response usually normal, so QRS complexes usually narrow
- If conduction is abnormal, may have right bundle branch block morphology
Management
- Depends on etiology and symptoms
Disposition
- Based on etiology and symptoms