Ventricular Premature Contractions Diagnosis at Age 50 – Frequent Heart Palpitations Are Warning Signals
(Disclaimer: This article is intended solely for educational purposes. Patient information has been altered to protect privacy.)
Palpitations can be more than just a fleeting discomfort—they may signal an underlying heart condition. In this article, we explore the case of a 50-year-old woman who experienced persistent heart palpitations and was eventually diagnosed with coronary artery disease and frequent ventricular premature contractions (VPCs). After undergoing a combination of interventional and medical therapies, her symptoms significantly improved and her quality of life was restored.
Case Overview
Patient: Female, 50 years oldDiagnosis: Coronary artery disease, frequent ventricular premature contractionsTreating Hospital: The First Hospital of Harbin CityVisit Date: May 2022Treatment Plan: Percutaneous transluminal coronary angioplasty (PTCA), balloon angioplasty, and a comprehensive medication regimen including isosorbide mononitrate, clopidogrel bisulfate, aspirin enteric-coated tablets, rosuvastatin calcium, and evolocumab injection.Treatment Duration: 7 days inpatient care followed by 1 month of outpatient follow-up.Outcome: Significant reduction in VPCs and complete resolution of palpitation symptoms.
Initial Consultation
The patient, a 50-year-old woman referred to as Mrs. Huang for privacy, came in complaining of persistent heart palpitations over the past two weeks. Her medical history revealed a previous diagnosis of breast cancer four years earlier, for which she underwent chemotherapy and continues regular follow-ups. Despite having no history of hypertension, diabetes, or smoking, she was diagnosed with frequent ventricular premature beats at a local clinic and had tried oral amiodarone without success.
An echocardiogram showed a significantly reduced left ventricular ejection fraction (EF < 38%). An ECG confirmed sinus rhythm with frequent VPCs. Based on these findings, she was initially diagnosed with arrhythmia and frequent ventricular premature contractions.
Treatment Plan and Intervention
After admission, the medical team prioritized ruling out coronary artery disease as the underlying cause. A coronary angiogram revealed a 50% stenosis in the left anterior descending artery and a 90% blockage in the posterior interventricular branch, confirming the diagnosis of coronary artery disease and frequent VPCs.
The patient underwent PTCA with balloon angioplasty at the site of severe stenosis. To prevent thrombosis, dual antiplatelet therapy with clopidogrel and aspirin was prescribed for six months. Intensive lipid-lowering therapy was also initiated using rosuvastatin in combination with subcutaneous injections of evolocumab to bring low-density lipoprotein (LDL) levels below 1.8 mmol/L. Additionally, isosorbide mononitrate was administered to improve myocardial ischemia.
Continuous ECG monitoring was performed for the first three days of hospitalization to ensure stability and monitor for any arrhythmia recurrence.
Post-Treatment Recovery
Within a week of treatment, Mrs. Huang's frequent VPCs showed marked improvement, and her palpitation symptoms had largely subsided. She was discharged after meeting the clinical criteria for recovery. A one-month follow-up plan was established, including repeat ECG, echocardiogram, and lipid profile assessments to monitor long-term cardiac function and lipid control.
Long-Term Management and Lifestyle Adjustments
While Mrs. Huang's condition improved significantly during hospitalization, post-discharge care remains crucial. Patients with coronary artery disease and VPCs must adhere strictly to prescribed secondary prevention medications. Discontinuation of antiplatelet or lipid-lowering drugs could lead to serious complications such as acute myocardial infarction or heart failure.
Regular monitoring of liver and kidney function is also recommended during long-term medication use. Additionally, patients should maintain a healthy lifestyle that includes adequate sleep, stress management, a low-sodium, low-fat diet, and regular physical activity. Incorporating whole grains and nutrient-rich foods into the diet can further support cardiovascular health.
Clinical Insights and Takeaways
Ventricular premature contractions are a common type of arrhythmia. When they occur frequently, they can cause noticeable symptoms like palpitations or a sensation of skipped heartbeats. These symptoms should never be ignored. In many cases, frequent VPCs may indicate underlying structural heart disease, such as coronary artery disease.
Timely diagnosis and a comprehensive treatment strategy—including both interventional procedures and long-term medication—are essential for managing this condition effectively. Patients experiencing persistent heart palpitations should seek medical evaluation promptly to rule out serious cardiac issues and begin appropriate care.