What does premature beats on an electrocardiogram mean?

Premature beats are a heart disease whose main symptom is abnormal heart rhythm. The name of premature beats was actually introduced from the West, and the detection of premature beats uses the electrocardiogram graph to identify them. Electrocardiogram can effectively detect the frequency of atrial fibrillation to diagnose whether there are premature beats.

Premature heart beat test

Electrocardiogram is diagnostic of premature beats. Atrial premature beats are early QRS waves preceded by an abnormally shaped P wave and followed by an incomplete compensation period. The QRS waveform is often consistent with the normal QRS waveform. The QRS wave of nodal premature beats that appears early is consistent with the normal QRS wave, there is no P wave before it, and the compensation period is complete. The QRS wave of ventricular premature beats appears early and is wide and deformed, and the compensation period is complete. The 24-hour dynamic electrocardiogram can record in detail the number of premature beats, the pattern of occurrence, the treatment effect, etc. Patients suspected of myocarditis can undergo blood myocardial enzyme testing. Cardiac ultrasound examination can detect cardiomyopathy and some patients with coronary heart disease. Patients who take diuretics for a long time or are suspected of digitalis poisoning should have their blood electrolytes measured and, if necessary, their blood digitalis concentration measured.

1. Symptoms of premature heart beats

Premature beats may be asymptomatic or may cause palpitations or a feeling of cardiac arrest. Frequent premature beats can cause symptoms such as fatigue and dizziness (due to reduced cardiac output). For people with existing heart disease, this can induce or aggravate angina pectoris or heart failure. Auscultation may reveal irregular heart rhythm and a long compensatory interval after premature beats. The first heart sound of premature beats is often enhanced, while the second heart sound is often weakened or disappeared. When premature beats are in a binomial or tripeminic rhythm, a long pause can be heard after every two or three heartbeats. Premature beats are inserted between two regular heartbeats and may appear as three consecutive heartbeats. Palpation of the pulse may reveal intermittent absence of pulses.

2. Diagnosis of premature heart beats

1. Medical history and symptoms

Due to the different sensitivities of patients, there may be no obvious discomfort or only palpitations, discomfort in the precordial area or a feeling of cardiac arrest. Inquiring about the medical history of hypertension, coronary heart disease, cardiomyopathy, and rheumatic heart disease can help understand the cause of premature beats and guide treatment. Pay attention to inquiring about whether there is a recent history of colds, fevers, and diarrhea to help determine whether you have acute viral myocarditis. The use of digitalis, antiarrhythmic drugs and diuretics may sometimes induce premature beats.

2. Physical examination findings

In addition to the positive signs of existing heart disease, auscultation of the heart may reveal an early heartbeat in a regular rhythm, followed by a longer interval (compensatory interval), an increase in the early first heart sound, and a decrease in the second heart sound, which may be accompanied by a weakening or disappearance of the pulse.