Patient presents with complaints consistent with ventricular bigeminy.  Symptoms reported include palpitations, skipped heartbeats, and occasional chest discomfort.  Electrocardiogram (ECG, EKG) confirms the diagnosis of ventricular bigeminy, demonstrating a characteristic pattern of premature ventricular contractions (PVCs) occurring every other beat.  Frequency of PVCs noted, and morphology assessed for uniformity.  Patient denies syncope, dizziness, or lightheadedness.  Medical history reviewed, including current medications, history of cardiac disease, and family history of arrhythmias.  Risk factors for ventricular bigeminy, such as electrolyte imbalances, myocardial ischemia, caffeine intake, and stress levels, were assessed.  Current vital signs stable.  Treatment plan includes further investigation to determine the underlying cause of the ventricular bigeminy.  Laboratory tests, including electrolytes and thyroid function tests, ordered.  Cardiac monitoring, such as a Holter monitor or event recorder, may be considered for further evaluation.  Patient education provided regarding lifestyle modifications, including stress reduction techniques and avoidance of caffeine and other stimulants.  Potential complications of ventricular bigeminy, including more serious arrhythmias, discussed.  Follow-up appointment scheduled for further evaluation and management based on test results.  Differential diagnoses considered included atrial fibrillation, atrial flutter, and supraventricular tachycardia. ICD-10 code I49.3 (Ventricular premature beats) assigned.