Premature Ventricular Contractions (PVCs, PVC)

  • Medical Author:
    Daniel Lee Kulick, MD, FACC, FSCAI

    Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

What are premature ventricular contraction symptoms?

Patients with mild infrequent premature ventricular contractions often report no symptoms (asymptomatic) and are unaware of their premature ventricular contractions. Their premature ventricular contractions may be discovered when an electrocardiogram (ECG, EKG) is performed for a routine physical, insurance physical, or preoperative evaluation.

Patients with premature ventricular contractions sometimes report palpitations in the chest and in the neck. Palpitations are discomforting feelings due to forceful heartbeats. The heartbeat immediately after a premature ventricular contraction is usually stronger (the heart ventricle contracts more forcefully) than normal. Patients with premature ventricular contractions may report feeling that the heart has stopped briefly. This is because there is usually a brief pause in heartbeat after a premature ventricular contraction when the electrical system of the heart resets. Moreover, the actual premature ventricular contraction beat may not be felt because the heart hasn't had time to fill with blood before beating so patients with PVCs often complain of "skipped" or "missed" beats.

Patients with frequent premature ventricular contractions such as bigeminy (every other heartbeat is a premature ventricular contraction), couplets (two consecutive premature ventricular contractions), or triplets (three consecutive premature ventricular contractions) often report no symptoms. But in rare occasions they may report weakness, dizziness, or fainting. This is because frequent premature ventricular contractions can diminish the ability of the heart to pump blood to the other organs (diminished cardiac output), resulting in low blood pressure.

Patients with three or more consecutive premature ventricular contractions in a row have ventricular tachycardia. Ventricular tachycardia that is prolonged can result in low cardiac output, low blood pressure, and fainting (syncope). Ventricular tachycardia can also develop into ventricular fibrillation, which is a fatal heart rhythm (see below).

Reviewed on 3/23/2016
References
REFERENCES:

"Sudden Cardiac Arrest." Cleveland Clinic. March 2010.

Simpson, R. J. Jr., et al. "Prevalence of premature ventricular contractions in a population of African American and white men and women: the Atherosclerosis Risk in Communities (ARIC) study." American Heart Journal 143.3 (2002): 535-540.

Zipes, Douglas P. and Hein J. J. Wellens. "Sudden cardiac death." Circulation 98.21 (1998): 2334-2351.

Medically reviewed by Robert J. Bryg, board certified in internal medicine with a subspecialty in cardiovascular disease.

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