There is nothing called Idiopathic VPDs . . . It may simply reflect our Ignorance !
VPDs are such a common cardiac arrhythmia . We also know most are benign .Still modern science demands to rule out structural heart disease in any patient with multiple VPDs.
When ventricles get irritated it reacts with VPDs . ( The irritants can be anatomical , physiological or primary electrical)
Echo can detect only anatomical irritants .We are recognising more such focus for VPDs . Hence idiopathic VPDs may simply reflect our ignorance ! A focused echocardiogram is required .
The following conditions are often observed in patients with recurrent VPDs
Posterior Mitral annular calcification (Especially in women ) -Annular VPDs
Aortic valve degeneration /Bicuspid aortic valve with calcification – Cuspal VPDs
Mitral valve prolapse in young -Stretch induced Pap muscle VPDs
Minimal pericardial effusions with adherent epicarditis
LV false tendons-Stretch VPDs
RVOT lipid focus -Subclinical ARVD
LVH and Hypertension -Fibrotic VPDs
Asymmetric septal hypertrophy
Scars in MI/ DCMs
infiltrations in RCMs (Any Interstitial heart disease )
(Conditions 7 and 8 are common disorders myocardium just included to complete the list )
**Please note ,above mentioned entites are anatomical irritants .There is a whole lot of physiological irritants
that can induce VPDs . ( Hypoxia, Excess catecholamines , K + fluxes , acidotic milieu etc ) .
*** Another group is primary electrical diseases inherited channel disease can induce VPDs
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Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: drsvenkatesan Tags: Cardiology - Electrophysiology -Pacemaker Cardiology-Arrhythmias echocardiography Infrequently asked questions in cardiology (iFAQs) valvular heart disease premature ventricular beats structural heart disease and vpds ventricular ectopic bea Source Type: blogs
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