ECG education

‘My heart feels like it’s fluttering, Doctor’

Vivienne Miller

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Abstract

Articles in this section are inspired by, but not based on, real cases to illustrate the importance of knowledge about ECGs in relation to clinical situations in general practice. Management is not discussed in detail.

Key Points

  • Ventricular ectopic beats result in an ECG with abnormal, broader QRS complex appearance; however, they are mostly benign.
  • Factors associated with increased risk for ventricular ectopic beats include hypertension, left ventricular hypertrophy and ageing.
  • Precipitating factors for ventricular ectopic beats can be psychological (e.g. emotional stress), physiological (e.g. exercise) and biological (e.g. thyrotoxicosis, severe iron deficiency anaemia).
  • A resting cardiac echo, 24-hour Holter monitoring and consideration of referral to a cardiologist are keystones of investigation and management.
  • Patients with uncomplicated ventricular ectopic beats occurring in less than 15% of a 24-hour period most often do not require antiarrhythmic drug treatment.