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
Also read
A crash course on ventricular ectopics
Dr.S.Venkatesan MD 