I get a few pvcs a day on ecg look the same but uncommonly ill get them that look a different morphology for one or two days. does it mean multifocal?

That is implied, but: can simply mean different conduction paths. Dominant mechanism of arrhythmias within heart muscle is cardiac re-entry due to damaged muscle cells; usually ischemia. Since arterial disease present if 1/2 of population by later childhood, optimize Ds drivers: e.g. NMR lipoproteins (e.g. LDL-P <400 nmol/L, Large HDL-P >9 umol/L), HbA1c <5.0%, Systolic BP <120 mmHg, No smoking, HFLC foods, as best Tx.