Premature ventricular complexes (PVCs) are one of the most commonly encountered arrhythmias and are ubiquitous in clinical practice, both in the outpatient and inpatient settings. They are often discovered incidentally in asymptomatic patients, however, can cause myriad symptoms acutely and chronically. Long thought to be completely benign, PVCs have been historically disregarded without pursuing any further evaluation. Newer data have revealed that a high burden of PVCs with specific characteristics can significantly increase a patient's risk of developing PVC-induced cardiomyopathy. The aim of this literature review is to provide further clarification on the identification of high-risk PVCs, subsequent workup, and the currently available treatment options. PVCs arise from an ectopic focus within the ventricles. Patients with PVCs can be either asymptomatic or have severe disabling symptoms. The diagnostic workup for PVCs includes electrocardiogram (ECG) and 24-h Holter monitor to assess the QRS morphology and its frequency. A transthoracic echocardiogram (TTE) is done to look for structural heart disease and cardiomyopathy. Management of PVCs should be focused on identifying and treating the underlying causes, such as electrolyte abnormalities, substance use, and underlying structural heart disease. Beta-blockers are first-line therapy for symptomatic PVCs. Nondihydropyridine calcium channel blockers, classic antiarrhythmic agents, and amiodarone can be considered as second-line agents. Patients who are unable to tolerate medical therapy should undergo catheter ablation of the PVC focus to prevent PVCinduced cardiomyopathy. PVCs are common in clinical practice, and it is vital to identify patients at higher risk for PVC-induced cardiomyopathy to facilitate early intervention. Patients with no evidence of structural heart disease and infrequent PVCs should be monitored closely, while those who are symptomatic should be treated medically. For those who have failed medical therapy, catheter ablation of the PVCs focus is recommended. Catheter ablation has been shown to reduce PVCs burden and improve left ventricular ejection fraction (LVEF) in those with PVC-induced cardiomyopathy.

Objective Antisynthetase syndrome is a condition that includes interstitial lung disease and inflammatory myositis in its definition. The interstitial lung disease of this syndrome can vary in severity and if not identified soon enough, can lead to severe respiratory failure. Here we present a patient who had a working diagnosis of acute eosinophilic pneumonia. He initially improved after prolonged hospitalization and course of high dose steroids. CT chest revealed interval improvement in his bilateral ground glass and reticular opacities but residual fibrotic interstitial lung disease. However, he decompensated subsequently with relapsed hypoxia during activity. We hope that this review will bring awareness to antisynthetase syndrome and provide tools for earlier diagnosis and treatment. The primary objective of this study was to review presenting symptoms, diagnosis, treatment and outcomes. This review is unique because we focused on antisynthetase syndrome that initially manifested with lung symptoms rather than myositis or skin changes. Methods We have performed a comprehensive review of 30 cases of antisynthetase syndrome in the literature (including our case). Results Total 30 cases reported, 17 male patients and 13 female patients. Only 43% of the cases presented with lung symptoms alone, while 57% of the cases presented with lung and muscle symptoms simultaneously. Conclusion This supports the fact that antisynthetase syndrome most commonly presents with lung and muscle manifestations simultaneously. The fact that our case presented with lung findings alone led to the delay in his diagnosis.

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