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.

How is premature ventricular contraction diagnosed (echo and stress test)?

Echocardiography

Echocardiography uses ultrasound waves to produce images of the heart's chambers and valves and the lining around the heart (pericardium). Echocardiography is useful in measuring the size of the heart chambers, the forcefulness of heart ventricle contractions, the thickness of the heart muscles, and the functioning of the heart valves. Echocardiography is therefore useful in diagnosing conditions that can cause premature ventricular contractions such as:

  • Mitral valve prolapse: Echocardiography can detect and measure the severity of mitral valve prolapse and other valvular diseases.
  • Muscle hypertrophy: Echocardiography can detect heart muscle hypertrophy (thickening of heart muscle) as a result of long-term high blood pressure.
  • Heart muscle damage: Echocardiography can measure the extent of heart muscle damage from heart attacks or cardiomyopathy.
  • Ejection fraction: Echocardiography can be used to calculate the ejection fraction of the left ventricle. Ejection fraction is a measure (estimate) of the amount of blood pumped during each contraction of the ventricle. Heart ventricles extensively weakened by heart attacks or cardiomyopathy will have low ejection fractions. Patients with low ejection fractions have higher risks of developing life-threatening ventricular tachycardias and fibrillations than patients with normal ejection fractions.

Exercise cardiac stress test (treadmill stress test)

Exercise cardiac stress testing (ECST) is the most widely used cardiac stress test. The patient exercises on a treadmill according to a standardized protocol with progressive increases in the speed and elevation of the treadmill (typically changing at 3-minute intervals). During the ECST, the patient's electrocardiogram (EKG), heart rate, heart rhythm, and blood pressure are continuously monitored. If a coronary arterial blockage results in decreased blood flow to a part of the heart during exercise, certain changes may be observed in the EKG, including increases in premature ventricular contractions and development of ventricular tachycardias. Continue Reading

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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