How are PVCs diagnosed?

PVCs can be difficult to diagnose because they occur at unpredictable intervals. In most cases, PVCs are difficult for the physician to detect during a routine physical unless the patient has one during the exam or has other signs of structural heart problems. In individuals without any known heart disease, PVCs often are discovered incidentally during a routine electrocardiogram (EKG) In patients with known heart disease, PVCs may be detected during other diagnostic testing for that condition.

A patient with symptoms of PVCs who consults a heart specialist will undergo an ECG, the standard test for diagnosing PVCs. It is relatively inexpensive, non-invasive and accurate. A Holter monitor, a portable ECG that provides 24 or 48 hours of continuous recording, may be used for patients who experience PVCs at least once a day. The information from a Holter monitor is very useful in determining the frequency of PVCs and correlating symptoms such as faintness or dizziness with the arrhythmia.

The American College of Cardiology recommends exercise testing – measuring the heart rate while the patient walks on a treadmill – for some patients with PVCs diagnosed by ECG.

Major heart centers like Cleveland Clinic also have other, higher level, specialized tests available for patients with PVCs who are unable to undergo exercise testing or who are at high risk for more complex heart problems. These tests may include cardiac MRI, cardiac CT, myocardial perfusion SPECT, coronary angiography or electrophysiology testing. Cleveland Clinic electrophysiologists perform more than 4000 diagnostic tests for arrhythmias each year, one of the highest patient volumes in the country.

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