What would cause bigeminy of PVC's in a young adolescent!?
Question:
Only hx is hemophilia.
Recently recieved clotting factor.
No cardiac history.
Recent trauma - fell from standing height
Previous complaint of shoulder pain, no pain right now.
12 lead - negative.
Currently on O2 @2 LPM
Asymptomatic, no chest pain or SOB.
PVC's are non perfusing.
Pt's HR is about 40, if you don't count the non-perfusing beats.
I'm at a loss for what might have caused the PVC's.
Thanks!
Answers:
PVCs in a young patient can be caused by many things: excitement/anxiety, drugs/meds and especially hemodynamic compromise. It might have been an easily corrected electrolyte imbalance (specifically Mg++, K+ and Ca++). They are often asymptomatic at such a young age because they are capable of tolerating much more (like a HR of 40)... I cared for a 21 year old male last night suffering from new onset depression and anxiety without any prior medical history. His HR was 40-50 with asymptomatic PVCs... ECG=NSR, labs WNL
Other Answers:
My baby had PVC's shortly after he was born...everything was normal and there was no apprent cause and they have not happened again.
Is there any narcotic use? That could be a cause in an adolescent patient.
Also if the rate is 40-50 w/ PVCs it is an underlying rhythm of Sinus Bradycardia with ectopic PVCs, not a Normal Sinus Rhythm.
Does he use caffeine? can cause them especially if he is dehydrated
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