SLOW HEART RATE (BRADYCARDIA)

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Having a slower heart rate when you’re at rest is typically a sign of good health. However, if it becomes excessively slow, it might indicate a condition known as bradycardia.

Under normal circumstances, your heart beats around 60 to 100 times per minute while at rest. But in cases of bradycardia, this rate drops to less than 60 beats per minute.

While some individuals may not experience any problems with this slower heart rate, it could serve as a hint that there’s an issue with the electrical system in your heart. Consulting a doctor is crucial in such situations to determine the underlying cause of the slow heart rate and whether any treatment is necessary.

Know your heart

The heart operates through a complex system of electrical signals that traverse its four chambers: the upper chambers, known as the atria, and the lower chambers, called the ventricles. These signals coordinate the heart’s rhythm, ensuring it beats steadily. However, sometimes these signals don’t fire as they should, resulting in what’s termed as arrhythmias, or abnormal heartbeats.

While some conditions cause the heart to beat too rapidly or flutter, bradycardia presents the opposite scenario. In this condition, there’s a slowdown in the intervals between heartbeats due to an electrical issue.

It’s possible to have a slower-than-normal heart rate without experiencing any noticeable symptoms. In such cases, the electrical activity of the heart might still be functioning properly but at a slightly reduced pace compared to the average person. Consequently, this condition might not even be diagnosed.

Even if diagnosed with bradycardia, it’s possible to remain asymptomatic and not require any treatment. However, this isn’t always the case, as some individuals may experience symptoms necessitating medical intervention.

Causes of Slow heart rate

Bradycardia becomes more likely as you age, although this is true for many heart conditions. The causes of bradycardia can vary significantly from person to person. Some potential factors contributing to it include:

• Previous heart attack or as a complication of heart surgery
• Certain medications, particularly those used to treat high blood pressure or other heart rhythm disorders
• Congenital defects or abnormalities present from birth
• Thyroid disorders resulting in hormonal imbalances
• Obstructive sleep apnea, characterized by frequent pauses in breathing during sleep

Symptoms

The primary concern with bradycardia is that your heart might not be effectively pumping enough blood to all the organs and tissues in your body. When this occurs, you may experience the following symptoms:

1. Lightheadedness or dizziness
2. Confusion or difficulty concentrating
3. Fainting episodes
4. Shortness of breath, either accompanied by chest pain or occurring independently

Additionally, you might notice that you become easily fatigued even with minimal physical activity.

If you regularly check your heart rate and find it consistently below 60 beats per minute, it’s important to be mindful of these symptoms.

If you don’t experience any other symptoms, you likely don’t need to rush to see a doctor immediately. It’s possible that you engage in regular exercise, and a slower heart rate could be indicative of your fitness level. However, it’s advisable to discuss it with your doctor during your next appointment to ensure proper monitoring and evaluation.

Diagnosis of slow heart rate

Diagnosing bradycardia can pose a challenge for doctors because it may not manifest consistently. Your heart rhythm can fluctuate between normal and slow rhythms.

To confirm a diagnosis of bradycardia, your doctor may conduct an electrocardiogram (EKG) during a period when you’re experiencing a slow heart rate. An EKG, which measures the heart’s electrical activity, can reveal abnormalities indicative of bradycardia.

If your heart rate appears normal during testing but you’ve experienced symptoms of bradycardia, your doctor might recommend wearing a 24-hour monitor to capture any intermittent episodes.

During the diagnostic process, your doctor will inquire about your personal and family medical histories, as well as any symptoms you’ve encountered.

Treatments

Treatment for bradycardia depends on its underlying cause. For example, if hypothyroidism is identified as the culprit, addressing the thyroid issue may resolve the heart rate problem.

If there’s no clear physical cause, your doctor might adjust medications that could be slowing your heart rate. In some cases, beta blockers are prescribed to relax the heart muscle. However, if they contribute to excessively slow heart rate, your doctor may adjust the dosage or prescribe an alternative medication.

If conservative approaches fail to address the issue and your condition poses a significant risk to vital organs, you may require a pacemaker. This small device, implanted in your chest by a surgeon, contains thin, flexible wires called leads that extend to the heart. These leads deliver small electrical charges to help regulate the heart’s rhythm.

If you receive a pacemaker, it’s essential to follow your doctor’s instructions regarding its operation and to be vigilant for any signs indicating potential malfunction.

When to see a doctor

If you or someone you care about experiences mild to moderate symptoms, it’s important to schedule a doctor’s appointment promptly.

However, if fainting, chest pains, or difficulty breathing occur, it’s crucial to call 911 for immediate medical assistance.

Feeling tired, having trouble concentrating, or experiencing increased difficulty breathing might sometimes be dismissed as part of the aging process. However, it’s essential to recognize that these symptoms could indicate something more serious.

When discussing your symptoms with your doctor, be sure to provide comprehensive information. If you’ve noticed that you tire more easily now compared to a month or year ago, it’s important to mention this to your healthcare provider.

Sources

1. Mayo Clinic: “Bradycardia: Definition,” “Bradycardia: Symptoms,” “Bradycardia: Risk Factors,” “Bradycardia: Causes.”
2. Johns Hopkins Medicine, “Bradycardia
3. Heart Rhythm Society, “Slow Heartbeat.”
4. Cleveland Clinic, “Abnormal Heart Rhythms.”
5. American College of Cardiology: “Bradycardia (Slow Heart Rate).”