The Hip: Preservation, Replacement and Revision

Discussion of PVCs

 


 - See: V Tach 
- More than 6 per min, 3 in a row, or R on T is pathological; 
-Note if they are from the same focus; 
- P waves may be present be will have no relation to QRS wave of PVC; 
- QRS is usually > 0.12 seconds w/ Left bundle branch pattern; 
- look for compensatory pause following PVC; 
- Bigeminy: one normal sinus beat alternating w/ one PVC; 
- Trigeminy: two normal beats followed by one PVC; 
- Unifocal:: arises from one site in the ventricle; 
- Multifocal PVCs: arise from different sites, & have different shapes; 
- increased risk for V. fib
- PVC on T wave
- increased risk for V. fib; 
- PVCs ordinarily occur just after T wave of a normal cycle; 
Causes of PVCs: 
1) Ischemia: Angina/MI 
2) Valvular Heart Disease/Mitral Valve Prolapse; 
3) HTN 
4) Medication Toxicity: 
- Digitalis 
- Aminophylline
- Epinephrine 
- isoproterenol  
5) Hypokalemia
6 Hypomagnesemia 
7) Hypoxia 
8) Met. Acidosis 
9) Cardiomyopathy  
10) Mitral Valve Prolaspe; 
11) Meds: Digoxin 
12) Hyperthyroidism 
13) Caffeine 
14) Anxiety 
15) Anemia, 
16) Normal Varient




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, June 9, 2011 12:21 pm