What does it mean when you have premature ventricular contractions (PVC’s) but also a zero calcium score and normal heart structure?

Can the presence of the PVC’s still be indicative of something bad? I asked this question to cardiologist David N. Smith, MD, owner of Premier Cardiovascular Care, Charlotte, NC.

Dr. Smith explains as follows, “The risk from PVC’s are related to risk of a heart rhythm abnormality that makes it difficult for blood flow and, in certain families, elevates the risk that the electrical system of the heart will become chaotic.”

In other words, the presence of PVC’s, whether you have a zero calcium score or not, becomes relevant if you already have a heart rhythm abnormality or are at risk for an arrhythmia.

This is not related to blockages in the coronary arteries, which is what the calcium score test looks for (hardened or calcified plaque deposits).

Dr. Smith continues, “This risk is different than the risk portended by a calcium score, which indicates risk of blocked arteries leading to heart attacks. In this light, the two are unrelated.

“The calcium score that is very high, however, may reflect ongoing atherosclerotic disease that secondarily lead to electrical system abnormalities manifested as PVC’s.”

Calcium Scoring

The test is done with a CT scanner and takes about 15 minutes. You just lie there while the scanner captures images of your coronary arteries.

As mentioned, the test looks at hard or stable plaque buildup. It does not see soft or unstable plaque.

For some people, the idea of a scanner (especially one that emits radiation) that looks inside the heart’s arteries can be enough to induce premature ventricular contractions on the spot from anxiety.

dr. smith

Dr. Smith is a published author, national lecturer and Yale-trained physician-scientist certified by the American Board of Internal Medicine in Cardiovascular Disease. 
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


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