Premature Ventricular Contractions
Premature ventricular contractions (PVCs), also known as ventricular premature beats, are premature ventricular activations originating from ectopic pacemaker sites below the atrioventricular node. A PVC following every sinus P wave is called bigeminy; a PVC occurring after every two sinus P waves is called trigeminy; two consecutive PVCs are called a couplet; three or more consecutive PVCs are called ventricular tachycardia. A PVC occurring between two normal sinus beats is called an interpolated PVC. PVCs are also classified as unifocal or multifocal according to their morphology and coupling interval relative to the sinus QRS complex.
TCM Pattern Identification and Medication Reference
|Common Symptoms
Clinical Description:
The main symptoms are palpitations, a sensation of chest oppression and distension along the flanks, with symptoms that may be triggered or worsened by emotional changes. Other symptoms may include belching and sighing, irritability, insomnia, and difficult bowel movements. The tongue is dark red with a thin, yellow coating; the pulse is wiry or knotted/intermittent.
In Plain Language:
- You may feel your heart racing or pounding, with a tight or full feeling in the chest and fullness along both sides of the ribs. These discomforts may be triggered or noticeably worsened by emotional changes.
- You may also burp and sigh involuntarily, feel restless, sleep poorly, and have difficulty passing stool.
- The tongue may look dark red.
- The tongue coating may be thin and yellow.
- On pulse examination, the pulse may feel taut like a string, or irregular with pauses.
|Treatment Approach
Clinical Description:
Soothe the liver and relieve constraint; regulate qi and restore the pulse.
In Plain Language:
- First, stabilize yin fluids in the body and reduce their loss (for example, through profuse sweating, dry mouth, or irritability), helping maintain internal moisture and stability.
- At the same time, promptly warm and support depleted yang qi, helping warm the hands and feet and strengthen the breath, and countering the “counterflow” pattern of cold extremities and a faint, barely perceptible pulse.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical Description:
The main symptoms are palpitations, stabbing pain in the precordial area that is worse at night, and other symptoms such as a dusky complexion and bluish-purple lips and nails. The tongue is dark purple or has ecchymotic spots; the pulse is choppy or knotted/intermittent.
In Plain Language:
- You may feel your heart racing or pounding, sometimes with a sense of alarm. There may be a needle-like stabbing pain in the chest around the heart, which may become more noticeable and uncomfortable at night.
- The face may look dusky or purplish, and the lips and nails may appear bluish-purple and noticeably pale.
- The tongue may look purplish and dark, sometimes with purple spots resembling bruises.
- On pulse examination, the pulse may feel choppy or irregular, with pauses or intermittent beats.
|Treatment Approach
Clinical Description:
Invigorate blood, dispel stasis, and unblock the vessels.
In Plain Language:
- Promote blood circulation and disperse blood stasis, helping the stasis to gradually resolve.
- Help improve the flow of blood through the vessels and ease discomfort such as stabbing pain, numbness, and coldness associated with stasis.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical Description:
The main symptoms are palpitations with sudden onset and cessation, and distension and fullness in the chest and epigastrium. Other symptoms may include a sensation of heat and oppression in the chest, restlessness, insomnia with vivid dreams, a sticky sensation in the mouth, poor appetite, sticky stools that are difficult to pass, and dark yellow urine. The tongue is red with a thick, white, greasy or yellow, greasy coating; the pulse is slippery and rapid.
In Plain Language:
- You may feel your heart racing or pounding, sometimes with a sense of alarm.
- These discomforts may start and stop suddenly, recurring repeatedly.
- The chest and upper abdomen may feel distended and full, creating an uncomfortable sense of pressure.
- You may feel a stuffy, warm sensation in the chest, as though there is internal heat and discomfort.
- You may feel restless and unable to settle down.
- You may have difficulty falling asleep or wake easily, and often have vivid dreams.
- Your mouth may feel sticky, and you may have a poor appetite or little interest in food.
- Stools may be sticky, with a lingering feeling that bowel movements are incomplete.
- Your urine may look yellow or darker than usual.
- The tongue may look red or bright red.
- The tongue coating may be thick and greasy, either white or yellow.
- On pulse examination, the pulse may feel smooth and rapid.
|Treatment Approach
Clinical Description:
Clear the Heart and transform phlegm; calm the mind and quiet the spirit.
In Plain Language:
- Clear constrained heat in the Heart and transform phlegm, with the aim of easing the effects of phlegm-heat disturbing the Heart and gradually reducing discomfort such as chest oppression, restlessness, and copious, thick phlegm.
- Calm the mind and ease tension and alarm, helping stabilize Heart qi and ease palpitations, uneasiness, insomnia, and vivid dreams, so that mood and sleep may become more settled.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical Description:
The main symptoms are palpitations, heat in the palms, soles, and chest, shortness of breath, and fatigue. Other symptoms may include a thin build, a weak voice and shallow breathing, dry mouth and thirst, tidal fever, night sweats, insomnia, and vivid dreams. The tongue is red with little coating; the pulse is thin and rapid, sometimes knotted/intermittent.
In Plain Language:
- You may feel your heart racing or pounding, sometimes with a sense of alarm or unease that is difficult to settle.
- The palms, soles, and chest may feel warm, with inner restlessness and a sensation of heat.
- You may become short of breath easily and feel noticeably tired, quickly running out of energy during activities.
- You may gradually lose weight and appear rather thin.
- Your voice may be weak and your breathing shallow; you may avoid talking much or tire after speaking a few sentences.
- You may have a dry mouth and feel thirsty, often wanting to drink because your mouth and tongue feel dry.
- You may experience episodes of heat in the afternoon or at night, and sweat during sleep, sometimes dampening your clothes or bedding.
- You may have difficulty falling asleep or wake easily, and often have vivid dreams.
- The tongue may look redder and brighter than usual.
- There may be little coating on the tongue, making its surface look relatively smooth and clean.
- On pulse examination, the pulse may feel thin and rapid, sometimes with intermittent pauses or irregularity.
|Treatment Approach
Clinical Description:
Tonify qi and nourish yin; calm the heart and quiet the spirit.
In Plain Language:
- Support the body’s qi and nourish yin fluids, with the aim of improving energy, easing dry mouth and throat, and supporting internal moisture and stability.
- Calm the mind and ease tension and alarm, helping mood and sleep become more settled and gradually easing palpitations and uneasiness.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical Description:
The main symptoms are palpitations, aversion to cold, and cold extremities. Other symptoms may include chest oppression and shortness of breath, a pale complexion, a preference for warmth, and sometimes chest pain. The tongue is pale with a white coating; the pulse is deep and slow or knotted/intermittent.
In Plain Language:
- You may feel your heart racing or pounding, sometimes with a sense of alarm or unease.
- You may feel cold and be sensitive to cold, with frequently cold hands and feet.
- Your chest may feel tight or uncomfortable, and your breathing may become shallow.
- Your face may look pale and lack a healthy flush.
- You may be noticeably sensitive to cold, prefer warmth, and feel more comfortable near a heat source.
- You may sometimes also have pain around the heart that causes discomfort or concern.
- The tongue may look pale and lack a healthy red color.
- The tongue coating may be white, making the tongue surface look pale.
- On pulse examination, the pulse may feel deep and slow, or have irregular pauses.
|Treatment Approach
Clinical Description:
Warm and tonify Heart yang; calm the mind and settle palpitations.
In Plain Language:
- Warm and support Heart yang, with the aim of strengthening its driving force and gradually easing discomfort such as sensitivity to cold, cold hands and feet, chest oppression, and fatigue.
- Calm the mind and ease tension and alarm, helping reduce palpitations and uneasiness and supporting steadier mood and sleep.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical Description:
The main symptoms are palpitations, sweating, restlessness, dizziness, and blurred vision. Other symptoms may include heat in the palms, soles, and chest; chest oppression and pain; tidal fever and night sweats; and restless sleep. The tongue may be pale or dark red, with stasis spots or patches and a thin white coating or little coating. The pulse may be intermittent, knotted, irregular, thin, rapid, hurried, or choppy, with a thin and rapid pulse most common.
In Plain Language:
- You may feel your heart racing or unsettled, sweat easily, feel irritable, and experience dizziness or blurred vision.
- The palms, soles, and chest may feel warm, with inner restlessness.
- Your chest may feel tight, sometimes with pain.
- You may experience episodes of heat in the afternoon or at night and sweat during sleep, sometimes dampening your clothes or bedding.
- You may sleep restlessly, wake easily, or have frequent dreams.
- The tongue may look pale or dark red.
- Small purple spots or patches resembling bruises may be visible on the tongue.
- The tongue coating may be thin and white, or scanty to almost absent.
- On pulse examination, the pulse may be very rapid and irregular, pause intermittently, feel thin and rapid, or feel choppy. A thin and rapid pulse is most common.
|Treatment Approach
Clinical Description:
Nourish yin and drain fire; nourish the heart and calm the spirit.
In Plain Language:
- Nourish the body’s fluids and clear deficient heat, with the aim of balancing excessive Heart fire and insufficient yin fluids and gradually easing discomfort such as restlessness, thirst, tidal fever, and night sweats.
- Nourish and calm the mind, ease tension and alarm, and help reduce palpitations, uneasiness, insomnia, and vivid dreams, supporting more restful sleep.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
References
- Guo Jihong. Holter Electrocardiography [M]. Beijing: People’s Medical Publishing House, 2003: 264.
- Published by the China Association of Chinese Medicine. Guidelines for the Diagnosis and Treatment of Common Internal Medicine Conditions in Traditional Chinese Medicine—Section on TCM Conditions [M]. Beijing: China Press of Traditional Chinese Medicine, 2008: 65.
- Chen Haozhu, Lin Guowei, Wang Jiyao. Practical Internal Medicine (14th ed.) [M]. Beijing: People’s Medical Publishing House, 2015: 1396–1396.
- American College of Cardiology. ACC/AHA/ESC Guidelines for the Diagnosis and Treatment of Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death [M]. Translated by Hu Dayi. Changchun: Jilin Science and Technology Press, 2006: 10–12.