Premature ventricular contraction: Difference between revisions
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*Drugs | *Drugs | ||
[[File:PVC10.jpg|thumb|PVC]] | [[File:PVC10.jpg|thumb|PVC]] | ||
[[File:PVC 1.png|thumb|PVCs]] | [[File:PVC 1.png|thumb|PVCs]] | ||
*[[Palpitations]] | |||
==Clinical Features== | |||
*May be asymptomatic, or may have [[Palpitations]] | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Palpitations DDX}} | {{Palpitations DDX}} | ||
==Workup== | ==Diagnosis== | ||
===Workup=== | |||
*[[ECG]] | *[[ECG]] | ||
*If PVC burden is large: | *If PVC burden is large, consider: | ||
**TSH | **TSH | ||
**BMP | **BMP | ||
**Magnesium level | **Magnesium level | ||
**Ionized calcium | **Ionized calcium | ||
==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>== | ||
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==Disposition== | ==Disposition== | ||
* | *Generally may be discharged (unless other indications for admission exist) | ||
==See Also== | ==See Also== | ||
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==External Links== | ==External Links== | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:Cards]] | [[Category:Cards]] | ||
Revision as of 00:19, 22 February 2016
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
Diagnosis
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 pt receives thrombolytics
- 1st line are beta blockers, options below[2]:
- Acute MI: Metoprolol 5 mg IV 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
- 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