Differential Diagnosis for ECG with Occasional Supraventricular Premature Complexes
Single Most Likely Diagnosis
- Supraventricular Premature Complexes (SVPCs): This is the most likely diagnosis given the ECG findings. SVPCs are common and often benign, especially in individuals without underlying heart disease. They can cause palpitations, which the patient is experiencing.
Other Likely Diagnoses
- Anxiety or Stress-Related Palpitations: The patient's symptoms of occasional palpitations could be exacerbated or caused by anxiety or stress, which can trigger SVPCs or make the patient more aware of their heart rhythm.
- Mitral Valve Prolapse: This condition can cause palpitations and is sometimes associated with SVPCs. It's a common condition that might not have been previously diagnosed.
- Thyroid Dysfunction: Both hyperthyroidism and hypothyroidism can cause palpitations and arrhythmias, including SVPCs. Given the patient's otherwise unremarkable past medical history, this could be a consideration.
Do Not Miss Diagnoses
- Wolff-Parkinson-White (WPW) Syndrome: Although less common, WPW syndrome can cause SVPCs and is a condition that should not be missed due to its potential for leading to more dangerous arrhythmias like atrial fibrillation with rapid ventricular response.
- Atrial Fibrillation or Flutter: These arrhythmias can sometimes present with palpitations and may be interspersed with periods of normal sinus rhythm, making them potentially missed if not carefully considered.
- Cardiac Ischemia or Infarction: While the patient has an otherwise unremarkable past medical history, cardiac ischemia or infarction can sometimes present atypically, especially in women or younger individuals, and should always be considered in the differential for palpitations and arrhythmias.
Rare Diagnoses
- Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC): A rare condition that affects the right ventricle and can cause arrhythmias, including SVPCs. It's more commonly associated with ventricular arrhythmias but could be considered in the differential.
- Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT): A rare genetic disorder that can cause life-threatening arrhythmias, often triggered by physical activity or emotional stress. While it primarily causes ventricular arrhythmias, it's a rare condition that could potentially present with supraventricular arrhythmias.
- Hyperkalemia or Hypokalemia: Electrolyte imbalances can cause a variety of arrhythmias, including SVPCs. While not directly a cardiac condition, they are important to rule out due to their potential to cause significant cardiac dysfunction.