ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Cardiac Arrhythmia: Premature Ventricular Contractions (PVC) - When The Heart Skips a Beat

Updated on March 18, 2015

What is PVC?

Premature ventricular contractions (PVC) are one of the most common, and relatively less dangerous type of heart rhythm disorders.
Almost every person has experienced the phenomenon of "skipped beat". A PVC occurs when the heartbeat is initated rather by the ventricles than the sinoatrial or sinus node.

This review is an attempt to give a relatively parallel focus to both digest-like language and a deeper understanding of this rhythm disorder. As PVCs are relatively common, people still tend to over-dramatize it's - nowadays considered normal - presence over a course of a normal day.

ECG characteristics of PVCs

  • Bizarrely shaped QRS complexes,
  • QRS wider than 120 ms,
  • They are not preceeded by P wave,
  • The T wave is usually large and its direction is the opposite of the QRS complex.

ECG finding of PVCs

Symptoms

People may report the presence of PVC with a feeling of a "skipped beat", often followed by a strong beat, and generally a feeling of suction in the chest, a feeling of flopping of the heart followed by a strong pound . There are other symptoms like:

  • feeling of fainting
  • chest pain
  • fatigue


When do these symptoms occur?

Premature ventricular contracions are usually asymptomatic, although symptoms may occur in stressful situations, often during prolonged stress periods, cardiac stress resulting from physical exercise. An adrenaline rush resulting from a scary situation or unexpected stressful environment can also cause trouble to normal heart rhythm thus causing ectopic beat.

Causes of Cardiac origin:

  • Mitral valve prolapse
  • Myocardial contusion
  • Myocarditis
  • Acute myocardial infarction (MI)
  • Tachycardia (Heart rate greater than 100/min)

Causes of Non-Cardiac origin:

  • Surgery
  • Infections
  • Electrolyte disorders (hypokalemia, hypomagnesemia, or hypercalcemia)
  • Medications (eg, digoxin, tricyclic antidepressants, aminophylline, amitriptyline, pseudoephedrine, fluoxetine)
  • Other drugs (eg, cocaine, amphetamines, caffeine, alcohol)
  • Hormone imbalances (eg, menopause in women)

Causes

Since PVCs are most of the time of benign nature, usually there's no abnormal cause behind a PVC. Since PVCs are frequent among healthy individuals too, the main cause can be:

  • Stress
  • Stimulating agents (caffeine, nicotine, amphetamines, cocaine)
  • Hyperventilation from exercise (higher oxygen levels in the blood due to increased breathing rate)

Are there other causes that may refer to an underlying abnormality?

Yes, there exist a huge amount of underlying conditions that may provoke PVCs whether it is mediated directly or not, cardiac or non-cardiac, the causes are as follows:

  • Bradycardia (Heart rate greater than 60/min)
  • Cardiomyopathy (Ischemic, Dilated, Hypertrophic, Infiltrative)


Dr. Stephen Sinatra on PVC

When to seek medical care

If the feeling of skipped heartbeats is causing troubles in the normal course of the day, and a stressful mental state is developing (eg, fear of aggravation of the current symptom, fear of death) or simply PVC is continuously generating symptoms thus generating malaise, medical advice should be sought.

Is the consultation with a family doctor the best choice?

In case PVC is experienced rarely, consultation with personal family doctor is absolutely enough. However if PVC is causing troubles both physically and mentally, emergency medical care is the most effective option to choose from.

In case I visit the ER, what should I expect from the physician?

Usually an emergency physician performs several procedures:

  • ECG in order to exclude other heart conditions, structural abnormalities causing similar symptoms
  • Laboratory tests also are common since electrolyte disturbances can cause abnormal heart rhythm

Further examinations

  • 24-hour Holter monitor in order to determine if a cardiac electrical instability is present
  • Electrophysiologic exam is recommended for patients requiring pharmacological treatment with symptomatic PVC and a normal heart structure, and patients with PVC and structural heart disease too, for whom risk of sudden cardiac death is considerable
  • Exercise stress test in order to exclude conditions like coronary ischemia, exercise-induced arrhythmias

Comments

    0 of 8192 characters used
    Post Comment

    • LawrenceS profile image

      Lawrence Stripling 

      6 years ago

      Very Nice. Full of great information.

    working

    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, hubpages.com uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: https://hubpages.com/privacy-policy#gdpr

    Show Details
    Necessary
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the googleapis.com or gstatic.com domains, for performance and efficiency reasons. (Privacy Policy)
    Features
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Marketing
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Statistics
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)