Premature atrial contraction causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Mugilan Poongkunran M.B.B.S [2]

Overview

Premature atrial contractions occur frequently in subjects with normal heart; however, patients with structural heart disease and coronary heart disease are at increased risk. Alcohol and coffee are considered potential precipitants of PACs. PAC's may also be more common in other medical conditions such as chronic renal failure and chronic pulmonary disease.

Causes

Life Threatening Causes

Life-threatening causes include conditions which result in death or permanent disability within 24 hours if left untreated.

• Acute cardiac allograft rejection
• Diabetic ketoacidosis
• Myocardial infarction
• Pulmonary embolism

Common Causes

• Calcium channel blocker
• Cardiac stress test
• Chronic renal failure
• COPD
• Coronary heart disease
• Dehydration
• Ephedrine
• Hypokalemia
• Hypomagnesemia
• Obstructive sleep apnea
• Pneumonia
• Subclinical hyperthyroidism
• Sympathomimetic agents

Causes by Organ System

Cardiovascular	Congenital heart disease, congestive heart failure, coronary heart disease, dilated cardiomyopathy, holiday heart syndrome, hypertensive heart disease, hypertrophic cardiomyopathy, mitral regurgitation, mitral stenosis, mitral valve prolapse, myocardial infarction, myocarditis, valvular heart disease, ischemic heart disease
Chemical / poisoning	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Alpha interferon, aminophylline, amiodarone, amlodipine, amphetamines, cocaine, digoxin, diltiazem, dobutamine, ephedrine, 5-fluorouracil, isoproterenol, phenylephrine, salbutamol, sympathomimetic agents, tacrolimus, theophylline, thiazides, verapamil
Ear Nose Throat	No underlying causes
Endocrine	Cushing's syndrome, diabetic ketoacidosis, metabolic syndrome, subclinical hyperthyroidism, thyrotoxicosis
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	Acute cardiac allograft rejection, cardiac stress test, cardiac transplantation, cardioversion, pacemaker malfunction, transjugular intrahepatic portosystemic shunts
Infectious Disease	Fever, myocarditis
Musculoskeletal / Ortho	No underlying causes
Neurologic	Subarachnoid hemorrhage
Nutritional / Metabolic	Dehydration, electrolyte disturbance, hypokalemia, hypomagnesemia
Obstetric/Gynecologic	New born
Oncologic	No underlying causes
Opthalmologic	No underlying causes
Overdose / Toxicity	Amphetamines, cocaine, digoxin, cannabis
Psychiatric	Anxiety disorders, bulimia nervosa, stress, Takotsubo cardiomyopathy
Pulmonary	Chronic lung disease, COPD, hypoxia, pulmonary embolism, hypercapnia, respiratory acidosis, pneumonia, pulmonary hypertension, obstructive sleep apnea
Renal / Electrolyte	Chronic renal failure
Rheum / Immune / Allergy	Acute cardiac allograft rejection
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	Alcoholism, caffeine, chocolate, heavy exercise, fatigue, idiopathic

Causes in Alphabetical Order

• Acute cardiac allograft rejection
• Alcohol
• Alpha interferon
• Amiodarone
• Aminophylline
• Amlodipine
• Amphetamines
• Anemia
• Anxiety
• Bulimia nervosa
• Caffeine
• Calcium channel blocker
• Cannabis
• Cardiac stress test
• Cardiac transplantation
• Cardioversion
• Chocolate
• Chronic lung disease
• Chronic renal failure
• Cocaine
• Congenital heart disease
• Congestive heart failure
• COPD
• Coronary heart disease
• Cushing's syndrome

• Diabetic ketoacidosis
• Dehydration
• Dilated cardiomyopathy
• Diltiazem
• Digoxin
• Dobutamine
• Electrolyte disturbance
• Ephedrine
• Fatigue
• Fever
• 5-fluorouracil
• Heavy exercise
• Holiday heart syndrome
• Hypercapnia
• Hypertensive heart disease
• Hypertrophic cardiomyopathy
• Hypokalemia
• Hypomagnesemia
• Hypoxia
• Idiopathic
• Ischemic heart disease
• Isoproterenol
• Metabolic syndrome
• Mitral regurgitation
• Mitral stenosis

• Mitral valve prolapse
• Myocardial infarction
• Myocarditis
• New born
• Obstructive sleep apnea
• Pacemaker malfunction
• Phenylephrine
• Pneumonia
• Pulmonary embolism
• Pulmonary hypertension
• Respiratory acidosis
• Salbutamol
• Stress
• Subarachnoid hemorrhage
• Subclinical hyperthyroidism
• Sympathomimetic agents
• Tacrolimus
• Takotsubo cardiomyopathy
• Theophylline
• Thiazides
• Thyrotoxicosis
• Transjugular intrahepatic portosystemic shunts
• Valvular heart disease
• Verapamil