Cardiac Medicine Certification (CMC) Practice Exam

In patients with significant PVCs, what may be a sign of hypoperfusion?

1. Regular strong pulse

2. Elevated blood pressure

3. Irregular pulse and signs of decreased perfusion

4. Increased respiratory effort

The correct answer is: Irregular pulse and signs of decreased perfusion

When evaluating patients who experience significant premature ventricular contractions (PVCs), the presence of an irregular pulse combined with signs of decreased perfusion can be indicative of hypoperfusion. PVCs disrupt the normal rhythm of the heart, which can lead to an ineffective cardiac output during periods of arrhythmia. This disruption may prevent adequate blood flow to the organs and tissues, manifesting as signs of reduced perfusion such as confusion, cool extremities, diminished capillary refill, and an irregular pulse. The irregularity of the pulse occurs due to the ectopic beats generated by PVCs, which cause the heart to beat in a non-standard rhythm. This can result in varying intervals between beats, affecting the overall volume of blood ejected from the heart and subsequently leading to symptoms of hypoperfusion. Understanding this connection is significant in cardiac care, particularly because the assessment of perfusion status is crucial in determining appropriate interventions for patients exhibiting significant PVCs. Recognizing signs of hypoperfusion allows healthcare providers to respond promptly and potentially mitigate any further complications arising from arrhythmias.