Premature ventricular contraction: Difference between revisions
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==Management== | ==Management== | ||
*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 | |||
*Correct electrolyte imbalances, particularly magnesium, calcium, potassium | |||
*Acute ischemia/infarction: | |||
**Complex ectopy frequently seen after pt receives thrombolytics | |||
**1st line are beta blockers, options below: | |||
***Acute MI: Metoprolol 5 mg q2 min for x3 doses, then PO metoprolol 50 mg q6hrs for 2 days, followed by maintenance of 100 mg bid | |||
***Post-MI: Atenolol 5 mg IV over 5 min, then repeat in 10 min, then PO atenolol 50 mg q12hrs for 7 days post-MI | |||
==Disposition== | ==Disposition== | ||
Revision as of 17:52, 26 August 2015
Background
- Abbreviation: PVC
Causes
- Digoxin
- CHF
- Hypokalemia
- Alkalosis
- Hypoxia
- Drugs
Clinical Features
- Palpitations vs asymptomatic
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
Workup
- ECG
- If PVC burden is large:
- TSH
- BMP
Management
- 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 pt receives thrombolytics
- 1st line are beta blockers, options below:
- Acute MI: Metoprolol 5 mg q2 min for x3 doses, then PO metoprolol 50 mg q6hrs for 2 days, followed by maintenance of 100 mg bid
- Post-MI: Atenolol 5 mg IV over 5 min, then repeat in 10 min, then PO atenolol 50 mg q12hrs for 7 days post-MI
Disposition
- Outpatient