Which symptoms are pertinent to the management of premature ventricular contractions (PVCs)?

Updated: Jan 13, 2017
  • Author: James E Keany, MD, FACEP; Chief Editor: Erik D Schraga, MD  more...
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Answer

Symptoms pertinent to the management of the PVCs are those that suggest underlying ischemic cardiac disease, such as chest pain or its anginal equivalent, or those suggesting hemodynamic compromise, such as lightheadedness or syncope. Note the following:

  • Patients are usually asymptomatic
  • Cannon A waves or the increased force of contraction resulting from postextrasystolic potentiation of contractility can cause palpitations and neck and/or chest discomfort
  • The patient may report feeling that his or her heart "stops" after a PVC
  • Patients with frequent PVCs or bigeminy may report syncope. a symptom that is due to either inadequate stroke volume or decreased cardiac output caused by the condition effectively halving the heart rate
  • Long runs of PVCs can result in hypotension
  • Exercise can increase or decrease the PVC rate

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