The medical term for a low heart rate is bradycardia. Sometimes a low heart rate is defined as below 60 beats per minute, but it would probably make more sense to have low heart rate defined as below 50 beats per minute.
Patients often ask if they have a low heart rate and whether there are a certain number of beats per minute below which they should be concerned. It’s important to realize however that the significance of a low heart rate is different in every case. Some people can have a heart rate of 40 beats per minute and have no symptoms and no long-term consequences. However in other people this can lead to symptoms and require treatment.
In some patients a low heart rate is found as part of a routine physical exam or study such as an EKG or a heart monitor. In other cases patients may present with symptoms and then found to have a low heart rate as part of the work up. Its very important to ensure symptoms are related to the low heart rate otherwise treatments such as pacemaker will have no effect whatsoever.
When I see a patient with a low heart rate I ask myself the following.
Is the low heart rate a physiologic finding or a pathologic finding? An example of a physiologic low heart rate would be an athlete with a low resting heart rate from being trained, which is absolutely fine. An example of a pathologic heart rate would be a disorder of the internal pacemaker system of the heart such as heart block that would often need a pacemaker inserted as treatment.
Is the low heart rate the likely cause of symptoms? Symptoms of a low heart rate may include dizziness and fatigue. In order to be attributed to a low heart rate the symptoms should occur at the same time the heart rate is low.
Are there any reversible causes for the low heart rate? Medicines such as beta-blockers or disorders such as hypothyroidism may lead to low heart rate and if the heart rate is dangerously low and causing symptoms as a result of this, stopping the medication or treating the underlying conditions will likely reverse the symptoms.
Why Could a Low Heart Rate be Bad in Some Situations?
The heart needs to pump out a certain amount of blood to provide the body with the blood it needs to function. The amount of blood pumped is known as cardiac output and is usually defined as liters per minute. Heart rate of course affects this output. In some patients a low heart rate can lead to a low output and cause symptoms such as dizziness, shortness of breath and fatigue. These symptoms are associated with low output heart failure. In other patients a low heart rate causes no effect whatsoever as the heart simply pumps out more blood with each beat to compensate.
The Conduction System of the Heart
The heart has its own natural pacemaker made up of a specialized collection of cells in the top chamber of the heart known as the SA node. This generates an impulse that travels through another collection of cells in the middle of the heart known as the AV node. The pathways taken by the impulses are known as the conduction system.
Problems with a low heart rate can be caused by dysfunction of the SA node, the AV node or the conduction system! It gets even more complex. The conduction system of the heart has many nerves attached to it; some of these nerves decrease the rate of conduction whereas others increase the rate of conduction. The nerves that decrease the rate of conduction and therefore lower heart rate are known as parasympathetic nerves. An example is when someone vomits; this can increase impulses in the parasympathetic nerves and slow the heart rate significantly for a while. This can even lead to passing out, which is known as a vagal event.
A balance of impulse from the sympathetic and the parasympathetic nerves determine a person’s baseline heart rate. Interestingly, in experiments where a person’s nerve supply is blocked, the heart rate is often higher; this would suggest that the parasympathetic nerve impulses that serve to slow the heart rate down are the predominant force under normal resting conditions. This is particularly evident at night when most people have a significant drop in heart rate.
When searching for a definition of a low heart rate, it’s important to know what is considered a normal heart rate. The normal resting heart rate is variable across the population and even between sexes. Most of the population is in the 50-90 beat per minute range, with heart rate dropping significantly at night. Not only does the heart rate drop at night, but also there is an increase in pauses and blocks. These are common enough to be considered normal variant at night that needs to be taken in to account when interpreting heart monitors.
Patients with sleep apnea, for example, may have very low heart rates at night that can be treated by sleeping the treat apnea.
Causes of Low Heart Rate
Firstly we will discuss things directly affecting the heart tissue and the conduction system called intrinsic disease. Aging is a common cause of slow heart rate, which results from degeneration of the conduction system of the heart. Heart attacks may damage areas of the conduction system also. Conditions that affect many organs of the body such as sarcoid, lupus and others can also affect the conduction system of the heart. Undergoing heart valve surgery such as the TAVR procedure for aortic stenosis, the mitraclip procedure for mitral regurgitation, mitral valve replacement or mitral valve repair, aortic valve replacement, or other complex heart surgeries may also cause trauma to the conduction system of the heart. Sometimes infection of the heart valves can extend in to the conduction system of the heart also.
Next we will discuss outside influences on the heart and conduction system known as extrinsic causes. Certain situations such as coughing, vomiting and others can lead to slow heart rate through the nerve system. Drugs that directly slow the heart rate include beta-blockers, calcium channel blockers and others. Metabolic disorders such as hypothyroidism can lead to a slow heart rate. Levels of electrolytes such as potassium derangement can lead to a slow heart rate.
Treatment of Low Heart Rate
In patients with confirmed or suspected slow heart rate, the underlying possible causes such as those outlined above need to be evaluated carefully. It’s especially important to review the medication list carefully and stop any potentially offending agents. Blood tests such as thyroid function studies may be performed.
An EKG is performed to see if there is just a slow heart rate or any evidence of heart block. Sometimes a monitor is worn to see the heart rate over time. Some people with a slow heart rate are unable to get their heart rate up with exercise known as chronotropic incompetence; this can be diagnosed with exercise testing. An echocardiogram may be performed to evaluate the heart structure and function.
What we do with a slow heart rate really depends on how bad the symptoms are. Its key to make sure the symptoms are related to the slow heart rate and that possible causes are identified and treated. The main indication for a patient without symptoms to get a pacemaker would be advanced heart block, long pauses in the heartbeat or rhythms that have the potential to lead to instability.
In patients that are symptomatic, and in whom underlying reversible causes have been ruled out, insertion of a pacemaker may be required. The choice of pacemaker for those with a low heart rate is different in different people and depends upon the level of block in the heart.
Well done… what about persistence in low rates after pacemaker ” intervention? thanks 4 the site…
In that case the pacemaker rate may need changing.
My husband has had all the tests to see if he has some blockages the dye test and all clear every test clear except for one test the ecg when he has his attacks it is always at night time lasts for at least 30 mins heart rate can go down to 34 on ecg has severe pain in chest jaw arms he is
Not sick or does not faint
People say it’s electric problem
Some have said angina he takes the spray
Some say panic attacks
It’s killing me not knowing
Help
What has been advised to you so far? have you seen an electrophysiologist?
My normal heart rate during the day is 60-70s. However it will drop once a day into the high 30s low 40s for about 10 minutes. This is not while sleeping. I get pretty dizzy along with short of breath to where I will wheeze. This happens frequently. All of my thyroid tests have come back normal. Had a dye test for a clot and nothing was found. It’s concerning to me. I also had a baby 10 months ago. Are there any other explanations?
You should probably be evaluated by a cardiologist and have some form of monitoring to characterize the rhythm. While its likely nothing of concern, an evaluation would be reassuring.
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I am suffering with a similar situation. Does he get a tingle on his lager side? Including foot and hand? What about cold, sweaty fingers & toes?
I am experiencing all that now. Sweaty body, tingling in toes and spasms in body especially at rest. Any changes or md advice since u posted?
my normal heart rate is 58 beats per minute. i have pots and a ligament laxity issue. in addition, i also have osteoporosis. is the low heart rate part of the pots diagnosis, or a whole different issue in of itself. i am 14. i’m really worried. someone please help me.
A rate of 58 isnt concerning as a low heart rate it is relatively normal.
Hello, 65 male, heart rate 40s at rest SR no block, asymptotic. With normal walking heart rate 60 to 70s. Been told nothing to do???
Same here. I had every test possible and no answers. My heart rate goes down to mid 30s and major pains in chest and hands. No blockage and No Answers yet. It gets scary but goes away after I walk or cough. I get these episodes every 3 months and they go away but yesterday I had 3 in one day. I’ve been to two different doctors and yet can’t get answers. Heart Cath showed no blockage and wore machine a week but these episodes didn’t happen while em wearing. I’m 48 and don’t really exercise because of a bad ankle. I’m about 25 lbs overweight and eat ok. I’m concerned and want to find a fix.
When sitting down, do you fall asleep as a result of low heart beat? Or are you as attentive as when moving around? I am concerned with a freind of mine that falls asleep when we are in meetings and he is not talking. Should I be concerned for him?
Unlikely unless it’s critically low and causing an emergency such as heart block. Your friend may want to get tested for sleep apnea with a sleep study.
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Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
I get the same thing. Happened to my grandfather too. Sometimes his heart would just stop. Sometimes mine just stops. He had to get a pace maker and eventually died. I’m 27 and fear my time here will be short if I don’t get help
How are you doing now ?
Hi Doc.
I am 40, male with diabetic, my heart runs slow sometimes, I do light running (30min) 4-5 days a week and some physicals, I weight 94KG now dropped from 107KG after diagnosed diabetics. My heart rate sometimes shows only 52 and BP 109/60. Mostly around 56-60-62. After my meal I have to have my medicine for diabetics after 1-2hrs of medication I feel bit dizzy and slows my heart rate as well. Is it cause of medicine? Do low blood sugar level drops hear rate? I suspect my medicine drops blood sugar level below par and it cause slow heart rate. I did some checkup and blood tests doctor said my heart is fine. What do I need to so please suggest.
Discuss your diabetes drugs with your dr. Also present to them a diary of your blood sugar levels at times of symptoms.
I have been in hospital twice overnight with slowing heart rate down to 38bpm. My EKG is fine only showed left ventricle. I wake with feeling chest pain. Now I walk 13 miles a day as a letter carrier. The most recent waking in morning was last week. I know I need to go to a Cardiologist but I do walk so much and I am baffled this happens at night or when completely relaxed, sleep well and wake with EXTREME chest pain that has sent me twice to emergency. In no way am I asking your diagnosis but when a hospital wants to ship me on a weekend to a Cardiovascular hospital without running 3 blood tests and 4 EKG’s I become suspect to insurance. I made them run them all as requested and was asleep when they found the above.
Why is my heart rate 43 and my blood pressure 135/72? Is this normal, I do have bradycardia and three cardiologist have said that they are no longer concerned about my low heart rate as all the testing I have done shows I have a strong slow heart and no, I am not an athlete, I weigh 240 pounds. I started working out twice a week with a trainer about three months ago, but testing/appointments have been going on for two years now.
While sleaping my heart rate drops as low as 35 is this normal? I have hypertension take lisinopril 10mg take 81mg asprin and zantac im not in shape i weight 235 and not very active my heart rate through day is 80s and above i monitor all this from my galaxy watch
Mine drops to 34 sometimes.
34!? Updates?
what r you doing now?
I had radioactive iodine therapy 3 months ago but still on methimazole. The past 2 days ive been having high blood pressure but low heart rate. Is it possible im going hypo? Im alsi on lisinopril and metopirol
The metoprolol may be contributing, if worried can check blood for thyroid levels and ekg to assess rhythm.
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Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
I was sitting. Eating a large meal. Suddenly felt a real electric shock. A zap. In the center of my chest. Followed by my heart feeling like it was yanked downwards. Like grab and pulled then a sudden racing heart.
Since then i get a heart rate of 40-55 laying in bed and 54-59 when sitting at night.
What’s these shock feelings. And the experience i had. What I’d that?
My resting heart beat is 54 during sleep and 58 when awake. I am 82 I walk 3 miles a day at a brisk pace.
Sir I want to ask that systolic dysfunction LV Ef 20-25%. What means this and what is treatment of this situation
It means the heart muscle is weaker than normal. Normal is 55-60%.
See if this post is helpful.
https://myheart.net/articles/what-is-heart-failure-everything-you-need-to-know/
You can follow our twitter at @MustafaAhmedMD
Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
For the past few days I’ve been having heart flutters / skipped heart beats throughout the day but they only last 1 second. Do you think it’s anything to worry about?
Having heads with my low heart of 39 to45.Ben taken same med long time never had this happen before,Would eating different food cause this?
Food is not likely to be related.
You can follow our twitter at @MustafaAhmedMD
Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
Not impressed because I have a low heart rate 34 BPM and don’t have any symptoms In fact, 8 years ago, a cardiologist attempted to place a stent on me and I refused. Then I asked my insurance Comp. for a well respected cardiologist for evaluation and he did a detailed 45 min testing on me and concluded that my heart worked as good as a 24 yrs old.. By the way, I am 74 yrs old, exercise every day, none smoker, none drinker, single, even temper and no life complications.
Hi, thanks for this site. Just yesterday I was informed my BPM was 29 and I’m not getting enough oxygen to my organs; according to a finger thing like taking your temp. The girl put it on herself and had about 110 calling that normal. I do occasionally (esp. that morning) get dizzy, normally I’m not dizzy but low blood pressure (90/60) most of my life I got dizzy standing up. I’m F 67, no chest pains, no arm pains nothing.
My suspicion is that I had surgery 2015 for sciatica and ever since then my left foot & both hands have tingling or numbness to the point of being unable to feel things at all. That occurs at night, I have dead hands. I’m wondering if the permanent nerve damage to my hands and left foot damaged something in my heart rate? I’m in pretty good shape and do stuff like I’m 30 not concerned about my age. Maybe I’m dumb but I don’t even feel effects of a slow heart beat. I do need more liquids so I can add more water to my diet. Someone said drink green tea is that beneficial? My PCP wasn’t concerned the week before but he didn’t time my heartbeats, he listened with a scope.
I had quadruple heart bypass two years ago this month. I am on beta blocker and potassium and my heart rate is in mid 40’s when I get up in morning. Then after I’m up awhile it goes into the 60’s and 70’s and 80’s . I have went into CHF a couple times after surgery. I have no heart damage or heart attacks that show up. Should I be concerned?
Hello Doctor , just wondering please , if whatever is happening to me is considered normal ? I’m female 32 y.o , walking around 10000 steps a day , slightly overweight. Not exercising much ….but
My resting heartbeat can go as low as 48 bpm , I’m not having any symptoms with it , feeling well .
During day while I’m out and about the heart rate is normal between 60 and 80 bpm . My blood oxygen level are between 98 to 100 everytime .
I also get something like ectopic beats ? Especially when I’m resting or eating fast , it lasting only 1 sec , and my heart doesnt look like its bother by it and beating peacefully… so my question is . Is low heart rate normal ? Also ectopic beats is there anything to be concerned about ? Thank you ever so much
How did you fair out with this? Seems very similar to me
Hi, same condition, but I am 37..have a 2 year old baby..should I worry abt resting heart rate of 57
Is it possible that the heart rate could drop 5 points after just 4 weeks of exercise? i am now at avg resting 57, i am by no means an athlete but i do , do cardio. also i noticed my heart rate drop to approx 51 @ night without sleeping, is this normal?
Heart rates typically fall during sleep and often when resting. If your level of fitness has increased significantly over the 4 weeks then its not overly surprising that your heart rate has dropped a little.
I am 66 and very physically fit. I play tennis occasionally and golf a couple of times a week. I go to the gym several times a week for yoga and dance class. My blood pressure is typically low at around 100/60. Recently, my pulse is 53 and below….sometimes 48 during the day. That seems dangerous to me. I had an EKG, and it was between 40-45……crazy!! The dr. said it just showed my fitness level. BUT I am not an elite athlete.
You are dead, but just havent realized it yet.
dead man walking
Have your thyroid and adrenal systems checked.
Hi, I just turned 39 (female) I am also an athlete. I have a resting heart rate of low 40s and mid 30s when at full rest/night time.
My Doctor as told me that it is because I am an athlete. I cannot believe this and am an anxious wreck all day everyday. I’ve lost 13lbs due to stress.
I have had a stress test, which was unremarkable and an echocardiogram, which was also unremarkable.
Yesterday I saw an electro-cadroligist yesterday. He said on paper, he can find nothing wrong. However, 30s is a bit too low. He is putting an implant monitor under my skin next week. We will go from there. He also told me to purchase a good bp machine and take my bp daily. He is trying to figure out if this is who I am or if my heart is “electrically acting up” i.e. Stopping etc. . I am a wreck, full blown panic all day/everyday.
Dude, friggin relax. You are healthy. Enjoy it. You will MAKE yourself sick with worrying. You are just predisposed to a low heart rate and you accentuate that by being fit. So get a good ribeye steak and a bottle of nice wine and congratulations!
My heart rate is in the low 40s all the time and I feel fine. Had many tests and doctors say I’m fine!! Guess we need to relax!! I’m a wreck too..and not near an athlete.
You should get your thyroid and adrenals checked. I had your symptoms of panic and found out it was my adrenals causing the problems. Look up adrenal insufficiency and see if you have the symptoms. Good Luck
31 year old female. I am not an athlete however I do go to the gym about 4 times a week. I have a resting heartbeat between 55 to 59. Is this normal or should I check with a doctor I do get lightheaded but its only every once in a while after getting up from a seated position.
My heart rate a couple times a night has dropped to 34 beats a minute. Is that ok. I’m 48 and pretty active. Female. Could you email me I’m not getting replies on this sight. And I would really appreciate your help.
Sincerely, Brandi B
I am 25 years old .I am by no means an athlete and do not do much physical activity but my heart rate is consistent at 60beats per minute ..Is it normal?? I sometimes feel vibration like sensation in my upper body mainlywhen I am stressed or have stomach problems.Thank You
Many would say 60 is totally normal. I would suggest a baseline EKG if you are concerned, in general a heart rate of 60 is just fine, especially if it increases with exercise. In reality lower heart rates are ok as long as not accompanied by symptoms of dizziness/fatigue/passing out etc.
I’m in the hospital earlier it was normal.. a little slow because it’s Been that way since I was younger. My drs threatening to stop the pain meds if it doesn’t go up? It’s 2:30 am my next does is at 4
HELP!
Sorry, its not possible to discuss in-hospital care and medications here. Hopefully you were able to sort the situation.
My husband age is 33 .He is not an athlete . His heart rate is 58 per minute. Is it normal or not sir
I am 68 y.o. and had afib 11 years ago. I had the ablation and sinus rhythm after that. Now. I have PACs with heart rate in the 70s. Went to 2 emergency rooms and kept me overnight. Sent me home with a cardiologist referral. Now a week later my resting heart rate is 36 to 50s and irregular. No meds. I’m worried. Why the drop. When I move around it’s in the 70s. Should I go back to the ER?
Hi,
My husband was electrocuted in August after gopher state one failed to mark an area that had live electricity running in the ground and he dug into 440v of current and was sent to the ER and he had high triponin levels for the day/night he spend in the hospital. The following day his levels returned to normal but he has been having palpitations, shortness of breath and dizziness. He wore a holter monitor for 24 hours and did a stress test, and EKG in Sept after he had a fainting spell. All those tests came back normal, he went to the VA as he is a veteran and they had him wear a z-pack for a longer period of time, he wore it for 4 days and they found his heart rate drops to 30-35 beats per minute. He is 50 years old and in great physical condition..his heart rate before the electocution was around 60 beats per minute. The VA want to do an ablation in is heart. I want him to see a cardiologist that is not from the VA becasue I don’t trust them. The cardiologist he saw that did the stress test, 24/hr holter and EKG has not seen the results from the 4 day z-pack. He had an ultrasound today where his heart rate went to 32 beats per minute. What are your thoughts on this? Should he go through with the ablation or would a pace maker be better?
What did they say they are trying to ablate?
Update?
Update on him?
My husband has a heart rate of below 50 and suffers from sleep apnea. His heart rate has been low his whole life. He has an enlarged aorta, which has been monitored for several years, and it remains under 5, and shows no change over the course of many years. He recently has started experiencing lightheadedness and dizziness upon getting out of bed in the morning. And also, he has started feeling dizzy when tilting his head back. Would you suggest a pacemaker with these symptoms?
I would recommend seeing a specialist. And the next step is likely to wear a monitor to see whats going on with the heart rate and see if there are any episodes that can explain the symptoms and to look for a correlation.
I am 33 and had issues with low heart rate after I had a baby in November, resting heart rate was around 40. Saw my PCP who did an EKG which was normal, heart rate on EKG was 56. She said probably just massive fluid shift after delivery. Baby is now 4 months and although my heart rate is usually high 50s and 60s (I wear a HR monitor on my watch) at night has dipped as low as 34 (although usually no lower than low 40s). I do consider watch to be accurate, sometimes I can feel my heart beating slow and I check and it I find watch to be right on. I am about 30 lbs overweight, but actively losing and am moderately active but by no means an athlete. Do you think that I need to see a cardiologist or does this sound OK?
Low heart rates can be normal, particularly in the setting of no symptoms. In those with sustained low heart rates particularly non athletes, i typically will have people walk on a treadmill to ensure that the response to exercise is appropriate. If you are worried and there are questions it never hurts to get an opinion.
This exact thing happens to me. I also just had a baby 7 weeks ago. I also have hypothyroidism which can cause a low hr., but dr. Says my thyroid levels are fine. It’s scary! Please share if you get some answers.
If your levels are fine how do you know that you have hypothyroidism?
Hi, this happened to me as well, in fall of 2015. I had severe symptomatic bradycardia after birth, with heart rates into the 30s and a lot of pressure in my chest and throbbing in my face, feelings of dread, feelings of being cold and an inverse rise in my blood pressure, which was historically on the low side. When my heart rate dropped, my pressure would rise. If I paced back and forth across the room, my heart rate would increase and my bp would drop, but as soon as I sat down and relaxed my hr would plummet and bp go up again and I would feel very ill. I was never able to get any answers, and after about 6 weeks it resolved for the most part, though I find my resting heart rate is still lower than it was before. I have done a lot of looking online and have found a decent size group of women who have experienced the same thing after birth. They typically have their heart rate fall 3-5 days post birth, become symptomatic, go to the er or their dr, have some tests done, and then are sent home after being told they are fine, though there is no explanation for what is happening to them. There are enough women experiencing the same thing that I’m convinced there is some kind of problem the medical community isn’t collectively aware of yet as it doesn’t seem to be common enough. It’s a very scary and frustrating experience to go through. I hope someone is able to research cardiac anomalies in the postpartum period and provide some answers. The best I was given was perhaps mild heart failure, though I wasn’t given an echo and therefore don’t have any hard evidence to back this up, and most of the echoes of women who I have found in discussion groups online have had normal results.
Hi, this is happening to me, it is so scary. I have an echo tomorrow and am taking water pills, lasix, seems to be helping somewhat, but my anxiety is out of control, i am so scared. Let me know if you find anything and I will do the same, hope you feel better soon.
I’m experiencing this now my baby is 4 weeks my heart rate is 34 and I have been having headaches and BP was 151 over 90 once I’m scared sometimes I cry I never experience any of this before birth
Postpartum pre eclampsia. You need to see your dr right away. I had it this past November and it’s very scary stuff. It resolved for me by 5 weeks postpartum
are you alive??
I’ve been having very low heart rates according to my watch and it dips during afternoon or when I’m sitting working. Goes to 40 … I am not active like an athlete. I feel
Like I’ve been having low heart rates since after had my daughter 2 years ago brought up to my Dr and had a heart rate monitor was told everything was ok. I seriously don’t feel good daily… low heart rates, fatigue, cold feet and hands, numbness tingly in legs and feet, weight gain. My thyroid tests were normal I was told. Any insight I feel like I’m going crazy, not having answers or energy plus anxiety over a low heart rate and scared to workout.
I am a 61 year old male. My heart rate is about 58 to 60 during the day time by 9 o’clock at night it starts dropping to low to mid 50’s. Then by midnight I wake many times with tingling or numbness in one of my fingers could be on either hand.
Then I find I can not sleep due to my body Jerking or jumping just as I am dropping off. I also feel nausea when rate drops below 60. I also have night sweats.
I have been to see cardiologist who said I have a murmur, I had a stress test and a ecg and I have another 4 weeks to wait before I have a echocardiogram. I feel as if I am not going to be able to go 4 weeks. I am on medication for high blood pressure.
I just found out I have a low heart rate. 56 year old male. I too have episodes where my body jerks at night falling asleep I hate it. I was in the ER the other day they checked out my heart and said it was fine. I also have a tingle that comes and goes quickly over the left side of my tongue when trying to sleep, not painful almost ticklish. Anyway I’m scared now about my low heart rate. Oh my hands fall asleep at night too that wakes me up. Have a doctors appointment in 10 days.
I am 27 years old and in pretty good shape. I’ve lost 40+ pounds in the last 4+ months from running a lot, playing basketball 3-5 nights a week, and eating a lot better. A few years back I had a resting heart rate in the low 40s, and it would go even lower at times (rhr was as low as 35 at one point in time) but I was also running 5-10 miles daily under 8 minutes a mile. I had a full cardiac work up because of a slightly elevated troponin level in the ER one time (I have been to the ER 30+ times in the last three years because of anxiety and this was the only time my troponin level was elevated at all) All of my tests came back fine back then (nuclear stress tests, 50+ ekgs, two echos, a 48 hour holter monitor, and possibly more) Over the last few weeks I have been noticing pain in my left arm when exercising and sometimes when not. I also get chest pains, but they’re not near as bad as they were before. My RHR lately has been anywhere from 44-47 over the last month. I asked my doctor, and he didn’t really say anything but he never does. I have two questions. 1.) Should I get another cardiac work up even though I had one done about two years ago? And 2.) I’m worried my heart rate is going to keep going down. I stress on my heart rate all the time. It goes as low as 38 when I’m laying in bed. I thought my Fitbit might have been off a little, so I checked it manually and it was right. It also seems to skip a beat here and there but only at night. *My RHR heart rate was in the high 50s to low 60s when I was out of shape.
Did you ever figure out what is going on ? I have similar. I work out daily but by all means not an athlete. My resting HR is 50-55. But have noticed it can drop in 40s when laying down watching tv and definitely fit bit has it dip in 40s while sleeping. It can even drop to like 47 or so when sitting at my computer job. Did EKG that was normal. So thinking better request halter and echo just to be sure. My doc said EKG would have shown block. But going to push for work up. I am a recent breast cancer survivor and did radiation on Left side. So that scares me.
Mine does the same and it scares me.
Wow Chris your story sounds almost exactly the same as mine. Did you ever figure out the problem.
That is exactly what is happening to me, inam 29 and goes around 42-46 didnyounfigure it out?
54 years old here and I am an athlete. RHR in mid to low 40s for as long as I can remember. I am a software engineer so am conscious of my long spells of immobility and balance it with a good diet, keeping active and lots of exercise. I don’t get dizzy when my head goes below my waist and it takes like 5 minutes for my heart rate to return to normal after a 5 miler.
I guess if I wasn’t so active and was experiencing brachycardia, I’d be a little worried to but for those of us who are used to pushing their bodies, this is the expected result.
If the guy in the picture was wearing athletic sneakers I certainly would have been concerned.
I am 33 and have always been a big guy. My heart rate has always run high. My “normal” heart rate usually is anywhere from 110 to 120bpm. I am also taking beta blockers.
I have been on the Atkins diet and have lost just over thirty pounds. In the last three days, my heart rate has dropped within the normal range of 80-100. Should I be concerned or can I contribute this to losing weight? I just wasn’t if it would drop drastically like that.
I tend to get paranoid and start to “feel” weird, but I am not sure if this is just anxiety. I read about Bradycardia and start to feel concerned about possibly having a heart attack and the electrical system is out of wack.
Currently, I don’t have health insurance and am also afraid to overreact and waste a hospital visit. I haven’t had chest pain or shortness of breath, but I have been feeling “odd” in the chest area, or upper area in general. I have also had headaches frequently.
I know it is difficult to consult without personally seeing someone and running tests or doing an EKG, but I figured I would get your feedback and hopefully put my mind at ease somewhat. I hate that I feel like a hypochondriac or just my anxiety is getting worse with age.
If your only concern is that the heart rate has dropped in to the 80-100 range, there is not much cause for concern, particularly if you don’t have symptoms. Good job on the weight loss. Im not sure what the weird feeling is. Remember bradycardia is much lower than the 80 range so you are nowhere near being bradycardic. Of course the answers here are not medical advice and i essentially cannot directly provide that in this setting. I suggest you go to a fire department and ask for an EKG to make sure its normal so it will reassure you.
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Dr my brother has heart disease and he’s been smoking cigarettes his heart rate dropped down to 35 can his heart get better if he stop smoking
hello,my name is Lillian and am 19 years of age. i would like to know,what happens when the heart is not exercised thoroughly and also, myself loves to participate in any sports especially, in schools, sports like,netball and rugby and athlete, so in this case,if am good in sports…does that mean my heart beat will slow and that shows my heart is healthy and normal. So for surely the heart rates will slow down when am resting or relaxing after an activity?…
thank you…
With exercise training there may be a drop in resting heart rate, it is physiologic in nature and a sign of athleticism and of no concern.
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I am a 43 year old male and I’ve been having my heart rate drop to the 40’s too. For the past 3 and a half months I’ve been dieting doint the atkins diet and have lost 43 pounds. My concern is that I was placed on high blood pressure medications and was taking them for over a year and just about 3 weeks ago got taken off them and my heart rate is still below 50. I’ve been getting some cold chills at times but only in cold places and some dizzy spells at times, is this a thing to be concerned of?
What did your heart rate used to be. A heart rate in the 40’s isn’t necessarily a bad thing at all, but its reasonable that if there has been a significant drop that it is worth investigating. Particularly in the absence of medicines and if there are symptoms such as dizziness, passing out, fatigue or light headedness. Its also important to know the response of the heart rate to exercise. A basic heart tracing is the best place to start.
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Hope to follow your helpful comments
My son is 22 and has had extreme fatigue over the last few months. His heart rate was checked today and it was around 54. It has stayed at 55 all day. He is currently taking Zoloft 100 mg & Olanzapine 2.5 mg. He has gained 30 lbs since he started the Olanzapine. He gets very little physical activity. I plan to take him to his doctor as soon as possible for an EKG but wondering if I should take him to a specialist instead. Could his medication be an issue. He does not smoke, do drugs and drinks rarely. I’m very concerned. Thank you.
My son is 22 and has had extreme fatigue over the last few months. His heart rate was checked today and it was around 54. It has stayed at 55 all day. He is currently taking Zoloft 100 mg & Olanzapine 2.5 mg for OCD disorder. He has gained 30 lbs since he started the Olanzapine. He gets very little physical activity. I plan to take him to his doctor as soon as possible for an EKG but wondering if I should take him to a specialist instead. Could his medication be an issue. He does not smoke, do drugs and drinks rarely. I’m very concerned. Thank you.
The extreme fatigue, weight gain and decreased activity may be related to the olanzapine and this should be discussed with the prescribing physician. A heart rate of 55 is not generally considered an issue in itself. I would recommend you start with a 12 lead EKG and the intervals on the EKG should be checked to ensure they are not deviant from the normal range. Certain medications can interfere with this and if the heart rate is a concern then the intervals should be checked.
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My resting heart rate is usually in the 50’s or 60’s. If I’m really relaxed and laying down it’s always in the 50’s and drops into the 40’s when I sleep. I have had a stress test, echo, and event monitor on, but all came back ok. The testing was done due to a vasovagal episode at the ER during a panic attack where my heart rate dropped from 100 to 26bpm. I’m still wondering if the heart rate monitor didn’t glitch (is that possible?), I felt panicked but not like I was passing out. Anyway, I was an active teen and younger person with always a low heart rate (40’s back in the day). At 35 I’ve gotten fat and at 5′ I weigh 188. I feel ok, but often tired (I’m seeing a sleep specialist who thinks I might have narcolepsy though?). Generally, however, I’m not tired at rest when my heart rate is low and I never feel dizzy. Can I be fat and have a heart rate that is low like that and have it not be an issue? (I’m working on losing weight and have lost ten pounds)
Low heart rate during sleep is common, especially in those with sleep apnea or obesity.
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I just recently bought a Fitbit and noticed my heart rate with go down into the 50s at night while I’m sleeping, or if I’m sitting and not doing anything. Is this normal? I’ve had ekgs and holter monitor and everything always comes back normal except my heart rate can be slow. My dad said his RHR is in the 50s and my grandmother, uncle and cousin have a slow pulse too. Can this be hereditary? My average BPM is 64 but I do have the dips into the 50s which concern me. Looking for your opinion. I’m 33. And 40lbs overweight, just recently started walking for an hour 5 days a week
Low heart rate during sleep is common and not generally of concern, especially in those with sleep apnea or obesity and with normal testing otherwise. Your increased activity is a great idea and will pay off.
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I’m forty-one years old and my normal resting heart rate is ninety or above. About a month ago I came down with what felt like a flu for about a week and during that week, my heart rate resting dropped to 54 – 57 bpm. This has never happened. Since I can remember my heart has always been a bit fast and for awhile I had to take pills for tachycardia. I’m about fifty pounds overweight as well so this is all strange to me. I feel tired during the day but just started taking Nudexta two weeks ago. Anyways, should I be worried or see my doctor?
54-57 is in general considered a normal rate. Low heart rate is more concerning if there is accompanying symptoms such as shortness of breath, passing out, dizziness, fatigue etc.. If you have had such a drop and you want reassurance i would suggest a simple check up with an EKG.
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I’m a 53 year old female, 5’10”, 135 lbs. I’ve always been active – play hockey, circuit training, bike, swim. My resting heart rate has been 40 and 44 tested twice over the last 2 months. I’ve had 2 ekgs, and have been told my QT is long. My blood pressure dropped 25-30 points overall when it was taken lying down, sitting, then standing. All my blood numbers are great. I’m fatigued and sometimes dizzy lately. My GP is referring me for a stress test. Any thoughts? I hit menopause 3 years ago. Thank you!
Many athletes may have resting heart rate in the 40’s. In this case your symptoms of fatigue and dizziness mean the heart rate may warrant further investigation. I would guess you are being sent for a wearable monitor, an echocardiogram, a treadmill test and some blood tests such as thyroid function. Also causes of possible orthostatic hypotension should be investigated. Its important to review medicines you may be taking and stay hydrated also.
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I m 22 year old …and I have jst low b.p prbm. Now present time my b.p has normal BT pulse rate is 54… Is it OK?
Depends on may factors. The heart rate of 54 can be perfectly normal. Does your heart rate increase with exercise?
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Am 36 female I’m current wearing a heart monitor my Dr has me wearing it due to my heart rate going but think its due to panic attacks but I been checking my heart rate while resting and it dtops into tube low 50s but raise when I’m up moving and during activity is that normal
Sounds normal response to increase with activity.
Hello my name is James and I’m 30 years old and have a slow heart rate for about 15 years now without any problems but as of the last 4 months I’ve been feeling a lot different. My heart will just speed up out of no where than I will get it to stop and go back to normal but last month I couldn’t get it to slow down so I went to ER and the told me I have atrial fibrillation. Am going to have concerning problems while being a bradycardia with Afib?
Not necessarily. I would suggest input of a cardiologist and potentially a monitor to characterize the nature and frequency of the arrhythmia.
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I am female, 63 years old. For many years my heart rate has been in the 50’s. I walk 1.5 miles almost daily. Today at a gyne check up it was 40. The doc called my PCP who has now ordered an EKG which I had done 2 years ago. It was normal. I read that an EKG won’t show anything unless your heart rate is low during the test. Is it worth my cost to get an EKG again? My husband, for another reason, just had an echocardiogram that cost us $900+ so I am hoping to avoid unneeded tests, especially if they just lead to other tests. Thank you.
An EKG would be a standard part of a work up for bradycardia, to rule out blocks and other potential causes of bradycardia. If the bradycardia is without symptoms such as dizziness, passing out etc. and the ekg is normal then this is reassuring.
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I’m a 39 yr old male I’m 6’1″/185 lbs. I am very active at work and wear a Fitbit and I log roughly 4.5 miles a day and burn about 450 calories a day. I recently went into the ER for heart palpitations and the doctor said that I have PVC heart. My resting heartrate is roughly 43-50 at night and 60-80 during the day. I have really low blood pressure 109 over 70. Today I woke up and had dull pains in my chest where my heart is and it comes and goes while having heart palpitations. I’ve taken an ekg and came back normal. X-rays are normal, I’m totally stumped what could be wrong with me. I’ve had pvc heart/palpitations for about 2 months. Is this something that I should see a specialist for a cardiologist? And.y help would be greatly appreciated.
Hi, while they may not necessarily be of concern, i think that you certainly should have a basic specialist evaluation with regard to the PVC’s. See if the following article sheds some insight.
https://myheart.net/articles/pvc-heart-beats-are-they-dangerous/
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I have a history of PVCs corrected by cardiac ablation. I’ve worn many monitors, had echos, cardiac MRI. I was cleared after ablation. In the past a monitor showed a low heart rate of 30bpm (before ablation). Recently another monitor showed heartrate of 40bpm (also only 200 PVCs). I do have random dizziness/fatigue, but I don’t believe at the same time as low heart rate. I have hypothyroidism, but it’s treated. I am not in great shape and some overweight. Years ago I was a runner, but now I’m scared to start working out hard if it’s going to make my pulse drop even lower. Is this a concern? Should I even worry about the low heart rate?
Its unlikely that initiation of exercise will cause a significant further drop in heart rate. Your case is relatively complex in that you have had ablation and a PVC history and therefore follow up with an electrophysiologist is key in determining the potential association of bradycardia with symptoms. I would recommend discussing this with the electrophysiologist and I suspect that the benefit of working out and staying fit would outweigh the risks.
Asalam o alaikum sir,i am 28 years old a few months ago my heart beat was suddenly high 110 resting and i used to take an inderal during the using of inderal my blood pressure was also high 160-110 then the doc advised me to take Dio plus 5/80 after the 5 dose of D plus my blood pressure suddenly down to 90/60 and pulse rate 61 beats per min .all the tests ekg ecg rfts cholestrol are normal .now a days my blood pressure remain 100/60 tp 110 and my pulse rate 60 per min in resting when i standing or eating heart beat increase 40 t0 50 beats per min so should i worry about this situation?
I have a question, I’m a 58 year old male with diabetes 2, 30 lbs overweigh and Post-Polio Syndrome PPS. During the day my heart rate fluctuates between 68-89 beats per minute. At night it usually runs between 42-58, but on some occasions it’ll run between 38-58 is this something I should worry about. I wear a Samsung Gear fit all the time and it’s shocked me and wakes me up at night when it drops between 38 and 48.
Heart rate drops in the night are common, particularly so in those overweight or with sleep apnea. It is not typically a cause for concern.
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I am a 28 yr old female, about 60 pounds overweight. I have been having chest and left arm pain as well as being lightheaded. I went to the er and they did a cardio work up and everything came back normal. Four days later I started to throw up and having the same symptoms again. The doctor at the er said it was anxiety. My resting heart rate is 56 to 60. Should I investigate this further or let it be?
The heart rate itself is not an issue here, 56-60 is fairly normal. Particularly given that you have had a work up.
I am a 62yr old female who has been diagnosed with Acquired Long QT syndrome after a heart spasm 5yrs ago. An angiography showed my heart as healthy. I have had several incidents of chest pain etc and a Heart Attack 18mth ago. My resting heart rate is in the 40’s going down to 38/39 sometimes and cause dizzyness and fatigue. I had a Nuclear Stress test two weeks ago and my heart rate got to 73 when I had severe chest pain radiating down my left arm, breathlessness and dizzy. I have just called for results as I have Gallbladder disease and the surgeon would not operate till I had checks. Was told they were ok and report would be with the surgeon next week. How can the result be ok if I am still getting symptoms of chest pain etc during exertions?
Of course any comment i make here is very limited in such cases as you would need full evaluation and history etc to make a well informed comment. When you had the chest pain, did you have any EKG changed accompanying? Have you ever had a stress echo? Have alternative causes been investigated? If spasm was occurring in the test, this should show on an EKG and also as an imaging abnormality. If all these factors have been evaluated, it is reasonable to assume that although you have the symptoms, you are in a relatively low risk category.
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Thank you for your reply. The spasm was originally diagnosed as a heart attack as it showed up in blood tests. Then Long Qt showed up and at the time I was taking Sumatriptan for migraine. Since coming off all meds five years ago I have had several incidents of chest pain etc but don’t always go to A&E. I have had an Echo which was ok. A treadmill test that I stopped because of breathlessness, which showed extra beats as my pulse rate slowed. Recent ECG’S have been ok but pulse low I can walk long distances its when I stop I get symptoms of chest pain, dizzyness and palpitations. Today at 10am pulse rate at 42bpm and BP 110/69 and I just want to sleep.
I am 46 year old female that has been having Trigeminal PVC for over a year, ECHO was good, had a medical stress tests that was the only time they could get me into normal rhythm have been told this is something I will just have to deal with. Now my heart rate keeps dipping into 36-38 frequently and my chest gets so heavy feels like it has to work so hard, and discomfort up both sides of my jaw. When I walk i feel almost SOB/ heavy chested. I usually walk 3-5 miles a 4-6 days a week, and pulse use to always be up in the 50-60, BP is low but I have always ran low. I feel like a fool going to the doctor because I feel like I am not believed, but it seems to be more frequent. My heart rhythm is all over the board lately.. Do i just continue to deal with it ?
Have you had a holter monitor? A monitor can characterize the frequency and nature of the PVC’s. If they are frequent and symptomatic I would recommend opinion from an electrophysiologist who can discuss treatment options. https://myheart.net/articles/pvc-heart-beats-are-they-dangerous/
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I really need your opinion or advice. My mom is turning 73yr oldand this coming July, she’s been having trouble of shortness of breath, and lately found out that she has cardiomegaly. She just began seeing two Cardiologist, the first Dr. Started her witha losartan due to her highschool blood pressure(which first BP medicine she ever taken in her lifeis). Few days after taking her meds, she noticed that she has been having few episodes of shortness of breathe and dizziness. So, she went to another Dr. For a second opinion, then he changed her prescription and wanted to try Norvasc once a day. Yesterday, my mom complained to me that her HR went down to 37, she was short of breathe and felt she was about to pass out. I’m worried about her condition; I am miles away from her, i cant watch her. The first doctor told her, she needed to go through a stress testand with dobutamine. Is it ok with her age to go through that procedure? Does she need togo continue her blood pressure medicine Norvasc? I need your help. Thank you!
A few points;
With regard to the medication, side effects can be noticed and its reasonable to try alternate ones to see which is tolerated. Norvasc isnt typically associated with a low heart rate. If she had a heart rate of 37 and felt she was going to pass out at that time she certainly needs evaluation and monitoring to characterize the heart rhythm. If she has those symptoms and feels that way again she should go to the emergency department to be evaluated. With regard to the dobutamine, that test is used and age itself is not a factor, although in my opinion, more information in this setting may be gained if she is able to walk a treadmill as a form of stress.
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Hi! I recently spent about a month in the hospital with pancreatitus. They couldn’t give me any pain meds because of persistent bradycardia. I have been out for about a week but now I feel like I am going to pass out every time I sit up. When I walk I’m bouncing off walls. My heart rate was in the 30-40’s while in the hospital but EKGs showed asymptomatic. So they said they couldn’t do anything. Any advise?
I advise keeping a heart rate, blood pressure and symptoms diary then presenting this to your Dr. If the symptoms are acutely concerning you should seek medical help as you may have dehydration also.
hello Dr i have the following questions.What are the risks of complications with different types of bradycardias?
What is a medical history and physical examination for slow heart rate?
What are the symptoms?
Most of the answers are in the article, do you have a more specific question?
My child has a slow heart rate, low of 33 average is 45. He is NOT an athlete. He had a holter, echocardiogram and EKG when he was 7 years of age and we were told all is normal. Not to worry unless he faints. Fast forward 7 years he is now 14 and fainted. We followed up with cardiologist and had a holter and EKG. Same results normal. Same low of 33 average of 45. He tires easy and has not fainted again. However we are working to figure out why the slow heart . He has been diagnosed with bradycardia. My son has an arachnoid cyst, syrinx of spinal cord and wonder if the heart rate would be slow from his neurological issues? Also would it be worth doing another echocardiogram again? Since he is older now would the heart change from age 7 to age 14? I understand that his structure of the heart was normal and no block 7 years ago. Any feedback or avenues to pursue would be great! ?
I recommend proceeding to a pediatric electrophysiologist at this point for evaluation and management.
We did see a electrophysiologist and he said not to worry and we would do a holter monitor every 6 months. We talked about an implantable heart recording and he felt that was not necessary. So I worry….because we don’t know what is causing the slow heart rate. My husband found an article about a possible issue from his arachnoid cyst causing a slow heart rate. We thought maybe you or one of your colleagues could give feed back or has done research on this…anyway thank you for your time and the quick reply??
Arachnoid cyst has not to the best of my knowledge been associated with bradycardia. If there has been an article written it is likely a rare case report.
Thank you so much!! You have a great web site going here!
I am a 31 year old female and have been experiencing a slow heart rate (40-60 at rest). However, when I move or get up, it jumps up until I stop again. My doctor said this is abnormal and has ordered a Holter monitor. She also did two EKGs on different days and both came back normal. I have been experiencing fatigue, dizziness, hair loss, and many more symptoms, but these do not happen only when my heart rate is low. I have a strong family history of autoimmune and thyroid problems, but my doctor said my TSH was ‘fine’ at 3.82. I truly believe my thyroid might be causing my heart issues, but my doctor has ruled that out. Do you have any thoughts or advice? Thank you!!!
The multitude of systemic systems means investigations should likely center on a systemic cause such as thyroid etc. Have you seen an endocrinologist?
I am 46 yrs old and been diagnosed bradycardia for 2yrs, my bpm is 44 average dropping to 38. My mother had cardio myopathy and died from a massive heart attack at 63yrs.
I get very tired all the time occasionally I have dizzy spells and light-headedness.
Am I likely to have the same problems as my mother?
Were you given a cause for the bradycardia and were causes such as hypothyroidism ruled out?
I had tests done but they couldn’t find a cause or any other problems with my heart, I mainly just suffer from extreme tiredness, I get pains in my chest but gp said it’s anxiety
Hi my name is Dusty….im 35 male. I work out 5 to 6 days a week lifting heavy… i use to run alot but now enjoy lifting …. my heart rate is usually what i think is normal all day and feel great….as soon as night comes i get tired and heart rate and blood pressure drops….one night it dropped to 100 over 40 with heart rate of like 55 …..felt fine if get up but when try go to sleep i feel like im passing out. I wear a watch at night my heart rate went to 42 …it scares me but i didn’t wake up dizzy or felling wierd ..
Ive never really checked any of this so not sure how low its been running…just wondering what could be going on…please respond…
The blood pressure mentioned, and the heart rate of 55 can be normal and in themselves are not worrying unless accompanied by symptoms such as dizziness, passing out etc. The heart rate decrease at night is very normal and seen in most people. The fact you are able to exercise to a good level is also reassuring. If you are worried about feeling tired and the symptoms before you sleep i suggest you get a routine check up and take a blood pressure and heart rate diary along to your visit. It is unlikely that the blood pressure and heart rate would be causing that and manifest at that time only.
Given the large amount of people we have been able to help here, we are starting a twitter to help keep heart patients up to date with advances and relevant information. Mine can be followed at @MustafaAhmedMD
Thank you for replying…..i would like to talk to you more if possible…
Dusty
As a weight lifter myself I have had that same feeling.Dizziness faint while trying to sleep. Total exhaustion waking up as well. I was on a strict keto diet at the time. One yer during the holidays i suspened my diet and i scarfed desserts and breads ..alot of carbs. I felt better and better everyday. I now eat some carbs in the morning like some toast and a donut and maybe an evergy bar before the workout and i feel way better. I am not as skinny as I used to be but feel great
Hi, thanks for this great site. I’m 59 with hx of sleep apnea well managed with CPAP. Have no other medical problems. I have had a HR of @ 60 for many years. The last 2 or 3 years my HR consistently runs 42 to 48, NO is fine at 110/60 to 70. I Take Modafanil 200 mg BID and had gastric bypass in 2007, losing about 80 lbs. I’m active but no athlete, and need to increase aerobic exercise. For the last several months I feel tired all the time for no reason…decent sleep and diet. My question is whether you think it worthwhile to see a cardiologist…seeing that my BP is fine AND only symptom is fatigue.
A start may be to see a primary care physician (if not easy to see a cardiologist), and obtain a treadmill exercise test to investigate the fatigue and ensure an adequate heart rate response to exercise. Some basic blood work such as thyroid function should be checked also.
Given the large amount of people we have been able to help here, we are starting a twitter to help keep heart patients up to date with advances and relevant information. Mine can be followed at @MustafaAhmedMD
Hello.
I am 50 years of age. Ever since I remember I have had a very low heart rate, usually sub 40. My max heart rate (maximal exercise) is around 120. I have a strong family history of heart disease.
My general symptoms are: I yawn a lot, have frequent short bouts of feeling ‘head foggy’, feel tired a lot, often feel like I need to ‘draw’ more air into my lungs and recently have experienced a dull aching feeling in my left arm.
Anesthetists have struggled to get a pulse prior to general ops so I was referred to heart specialist. ECG, Echocardiagram, 24 hour monitor confirm low heart rate but no electrical fault.
Can you advise?
Have you seen an electrophysiologist? Although your tests so far have been relatively reassuring, given a heart rate in the 30’s it may be worth seeking an opinion from an electrophysiologist.
If you are interested in cutting edge information and therapy for heart disease then follow my twitter at @MustafaAhmedMD
Paul, I have been reading through comments which are similar to what my son is experiencing. That being said, I would like to comment on your symptoms. I too yawned a lot felt like 500 yawns every afternoon. I kept seeing my internest who kept testing my thyroid. I went for a sleep study which turned out normal. Often felt like my yawns weren’t deep enough and needed more air. 4-5 years I felt this way. Then I started having gastrointestinal issues. Went to a gastroenterologist 3X over the next 4 years and he couldn’t find anything wrong with me and told me to take a pill when I had symptoms … severe stomach cramping, gas, and diarrhea and vomiting. A friend told me they thought I might have food allergies. What did I have to lose … I went and had the 300 food allergy blood test (not covered by insurance). I was allergic to yeast (vinegar, mushrooms, all alcohol re fermentation / brewers yeast, skins of grapes and plums, bakers yeast), gluten, and many other foods. It was not easy but I stopped drinking, eliminated all breads except GF Wraps, read all labels and just about everything had vinegar in it as a preservative! And eliminated the other foods I also tested positive for. Within a week ALL of my symptoms disappeared. I made an appointment with my internest and another one with my gastroenterologist and brought ALL of my food test results with me. Totally disgusted with the amount of time, energy, symptoms etc I spent and told them they needed to get educated! The gastroenterologist’s Physician Assistant spent 1 1/2 hrs with me and was very interested. I strongly suggested they offer this test to chronic patients like myself who had severe symptoms and no positive diagnosis through their exams. I am totally symptom free and feel like a normal healthy person again. Back to running, skiing, golfing, long bike rides, and pickleball!
Good luck to finding out what causes your symptoms. You have to be your own advocate!
Hi. I’m 28 yrs old. For 3 yrs I’ve been having health issues. While pregnant I started having issues with my heart, the cardiologist said it was do to my weight and it would go away after pregnancy. But out only got worse. My HR can be anywhere from 110-150 while standing/walking. Lowers when at rest. This leads too chest pain and difficulty breathing. I have dizzy spells, joint pain, memory loss, sensitivity to hot or cold, blue extremities, recently my BP has been increasing, physical and mental fatigue. I’ve seen another cardiologist that believes I have dysautonomia, but turned me away bc he “couldn’t” help me. My neurologist is not sure what’s wrong, she sent me to rheumatologist. That doctor doesn’t seem to take me serious. My ANA is positive, but he doesn’t think it’s lupus. He tested me for hep a,b and c. Which came back normal.
Please help, I’m starting to think I’m crazy.
I forgot slurred speech or I misspronouce words. Things that were once easy are now hard like spelling and math
Did you ever find out anything?
I’m a 22 year old female and not particularly active. My resting heart rate tends to be in the 50’s. Although after lying down for a long time (but still awake) it can drop to 46-47. I’ve been getting light headed spells recently that last about half a minute and have been feeling very tired but I’m not sure if this is linked to my low heart rate as sometimes my heart rate is 49-50 and I feel fine. I do get some palpitations but try to ignore them. I’ve had a few standard ECGS over the last few years which usually say sinus bradycardia but otherwise normal, although I’ve never had one taken during a dizzy spell. The doctors have just said my heart rate is low because I’m young and healthy. My heart rate does increase when I’m excercising into the 100’s. I also have been getting muscle twitches in my calves. I’ve recently been on a liquid diet due to undiagnosed swallowing problems and had endoscopy, FBC, liver, thyroid, iron, B12 and vitamin D blood tests all come back normal. Are the lightheadedness/fatigue spells likely to be heart related or could it be something else like low salt?
A rate in the 50 is relatively normal. I would suggest a symptom diary. Whenever you have the spells of dizziness or light headedness then measure your heart rate at that time and record it, ideally you would measure blood pressure at that time also. If the dizzy spells are frequent, i.e they definitely occur on a weekly basis, then you may benefit from a monitor to characterize your heart rate and rhythm at that time.
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My daughter had surgery for the gastric sleeve about 5 weeks ago. She started feeling bad and I checked her blood pressure to find out her heart rate was 44. I took her to ER and she was dehydrated and low on potassium. After 4 days in the hospital, her heart rate is still 35-55. One Dr wanted to put a pace maker but the other Dr on call wanted to wait in case it has something to do with her surgery. The Drs are not sure what’s going on. Her heart rate prior to surgery was 75. I can’t sleep because I’m up all night checking her heart rate. Is there a correlation between gastric sleeve surgery and low heart rates?
Post surgery a low heart rate can be seen at times due to pain or other reasons. A low heart rate has been described in some patients after gastric bypass surgery although i’m not familiar with the association after the gastric sleeve. Im not sure why there was a discordance in the opinion of the consulting cardiologists, if you are concerned i suggest firstly she have some form of monitor to assess and characterize the heart rate and rhythm and also that you seek opinion of an electrophysiologist. A heart rate in the 40’s is not necessarily bad if blood pressure is stable.
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Hello Dr Ahmed and thank you for a helpful site.
I am a 57 yr old man. Overweight (mostly round midriff) and being treated unsuccessfully with CPAP for apnea. Reason being I feel so tired despite the treatment.
I have a slow, resting heart rate of 46/48 and has been as low as 42bpm but my GP is unconcerned given I have a laborious job. Fair enough but by mid afternoon I feel so exhausted I could lay down and sleep! Although I am on oral medication for blood pressure, diabetes, statins and depression he assures me none of my tablets will cause my heart rate to slow.
A few years ago during an ECG at hospital I was found to have a right bundle branch block. However I was told it was quite common and not to worry.
I also had a period of dizzy spells at work especially when standing after getting out of a vehicle but that seems to have passed and I’ve had no further episodes of dizziness for over a year now.
My lovely American sleep apnea nurse thinks I may have something else going on other than my apnea. That’s why I ended up on your site trying to learn if there could be reasons for my slow heart rate and exhaustion.
Thank you again.
A low heart rate is not uncommon in those with sleep apnea, particularly at night and is not generally an issue. In this case it would be interesting to see if your heart rate mounts an appropriate response to exercise i.e when you exert yourself is your heart rate going up as it should. Also given the tiredness you are experiencing, the low rate and the right bundle branch block a treadmill exercise test and echocardiogram scan of the heart to assess underlying structure and function may be a good idea.
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For about a month now I been having fluttering in my chest and I started to check and record my heart rate. Resting while awake when I feel the fluttering my heart rate is always below 45 lowest 43 with just a little light headness. I don’t feel the fluttering if my heart rate is above 56. Should I see a specialist about this? I’m 37
I would see a physician for a check up, a baseline ekg and to determine if any further testing is required.
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Hi I am 33 and 6 weeks pregnant and my resting heart rate is as low as 40-45, I exercise about 5-6 days a week. I normally jog for about 30mins. After my work I have energy for about 3-4 hours but afterwards I am exhausted and tired. I am also a vegetarian so it’s very hard to eat the right foods at the right times because I am so busy. I have dizzy spells every now and then and it can get hard for me to concentrate. I have not told anyone any of my doctors about this. What steps should I take first?
The pregnancy may well explain these symptoms. The heart rate of 40-45 isn’t necessarily worrying although with the dizzy spells i would recommend a routine check up and exam and at least a baseline EKG to see where to go next.
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I have had recurring episodes of severe pressure in both upper arms, near the elbow. It is painful and feels like it is sucking the life out of me. My GP has sent me for stress test, echocardiogram, CT brain, carotid ultrasound, MRI of spine and vertebrae, and CTA of neck with contrast. Nothing has given an answer to the pressure, and it has continued periodically. I also experienced dizziness and difficulty breathing while in church and was taken to ER. This ER visit and one previously showed fluctuating blood pressure and heart rate down to 38 and up to 52. EKG and Blood work indicate no heart attack. Both times I was given no answers and just told I tolerate it well. Do you have any info on the extreme pressure in the arms, and is fluctuating BP and low heart rate causing any damage to heart? I am 75 and get little exercise. Thank you for your expertise and willingness to help!
The symptoms you have clearly appear disabling to you. The good news is that most of the immediately threatening things are ruled out from a cardiac point of view. If your echo and your stress test are ok then i’m not sure i would pursue further such testing. In terms of the heart rate, the rate itself should not be associated with pressure in the arms. If the heart rate is as low as 38, i would suggest some form of monitoring to characterize the rate and rhythm of the heart. The low heart rate itself will not directly damage the heart. In terms of the BP i would start with a blood pressure diary and maybe 24 hour ambulatory monitoring to see the peaks and lows and determine how to treat it best.
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I’m a 56 year old woman with a twenty-plus year history of severe anorexia (restricting type only). I’ve been in full sustained remission for over four years. For the last three months, I’ve been experiencing GI symptoms which include abdominal pain which worsens after eating, nausea, loss of appetite and as a result I’ve lost a significant amount of weight and my BMI is now about 19. I’ve been exhausted, but more recently dizzy and I’ve been having palpitations for the last around four
days. My heart rate has dropped in the last two weeks from being in the 80’s to now 60. This morning I was too dizzy to sit upright at my desk to work. I’m hoping this resolves quickly.
Although a heart rate of 60 is basically normal, given the dizziness and such symptoms an EKG may be a good idea. If palpitations are new and there are GI symptoms checking electrolyte levels with a blood test may also be recommended.
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I’m a 27 year old female. I just had my second baby a month ago. I eat semi healthy and don’t necessarily exercise. I was more active before giving birth than I am now since it’s hard to take a newborn outside in this heat. My bp was high toward the end of my pregnancy so they put me on labetalol 200mg 2x a day which dropped my hr to 40. They took me off then my family dr put me on labetalol 50mg 2x a day which lowered my heart rate so they took me off of that this past week. Now I’m on 250 mg of methyldopa 2x a day. And 10mg of paxil for anxiety . My rhr varies but rightnow it’s 54. When I stand up and move around it increases. Should I be worried? I had an ekg done this past week and the Dr said everything is completely fine. Also, in the morning i get anxious because I have to take my bp and my pulse goes up to 110-130 . What are your thoughts?
I should also add, I have no symptoms.
Thats very reassuring!
The heart rate itself is not necessarily a cause for concern and its reassuring that the ekg was normal. It would be more concerning if there were pauses, dizziness, passing out etc. Slower heart rate has been described with use of methyldopa and it may be associated. Keep a heart rate diary and take this to the practitioner next time you visit.
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I am a 34 year old male with severe anxiety. My heart rate is consistently between 46 and 55. I am symptomatic and have had EKG, Stress test, Echo and event monitor. Cardiologist says it’s not my heart causing my symptoms, extreme fatigue, nausea, light-headed, increased anxiety. Symptoms have been undiagnosed for over a year. I notice my symptoms when my heart rate drops. Could this be my anxiety causing my low heart rate? Any suggestions? I feel so hopeless
Anxiety is not likely to be related to low heart rate although some of the associated medications may be.
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I just got an Apple Watch that monitors my heart beat every few minutes. My heart rate ranged from 34-107 yesterday and 31-120 today. I’ve had a stressful couple of days at work but I can’t say I felt any symptoms like faintness or shortness of breath. My dip in heart rate today was during mid morning. Should I be concerned? I’m 30 years old, very overweight, and treating my sleep apnea with a cpap which I use consistently. Thank you.
The watches are know to be inaccurate at times. Was the 30’s rate overnight? In those with sleep apnea, overnight dips may be common.
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Dear Sir,
My name is Mohsan Nazir, I am a heart patient. I have Six stents in my heart by Angiography.
First operation dated January 09, 2017 after first heart attach,
Secand operation dated February 20, 2017,
Third operation dated April 03, 2017
From Straubing Germany.
I regularly take medicines and routine checkup.
Dated 14.07.2017 i feel sharp pain in my both arms and chest.
I have continuesly intense pain in both arms and chest.
So urgently i contacted to my Doctor Stadtgraben 93 94315 Straubing. He examined and recommend me medicines
“Novaminsulfon – 1 A Pharma Tropfen”
“Nitrolingual akut Spray”
When i use this spray then some lack of my sharp pain. But this is temporary, i am not feel well.
After complete tests my Doctor give me appointment for Forth operation dated August 04, 2017 time 12:30.
But they are not sure exactly what is the problem. All tests reports are good stents conditions, blood pressure everything is good. What is the reason of pain they cannot say anything. That’s why they suggest to doing forth time Angiography or Angioplasty
SO i am not satisfy, that’s why i contact with you kindly send me guidance or opinions that what is the reason of this sharp pain in my both arms, and what cause of doing Forth operation.
Now My heart speed is 55.
Waiting your guidance and opinions!
Best regards
Mohsan Nazir
It not really possible to comment without detailed records and viewing the angiography films. Have you tried seeking a second opinion there?
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I am a 60 year old woman with type 2 diabetes and high BP, I take metformin and losartan. I am about 25 pounds over weight. I am not athletic, I do work on my feet as a nurse 8 hours a day. My question is my heart rate had started dropping to the high 40 to 50s when at rest or laying down but if I exercise it goes up, then wI’ll go back down when finished. I have 2 sisters and a brother with hashimotos thyroid disease, should I be checked out for heart rate and thyroid. I don’t have any other symptoms , but has disease does run on male dude of family. I also had calcium scan with result of 0, and ekg in Feb that showed normal sinus rhythm .
I think checking thyroid is an excellent idea. The heart rate itself is not necessarily an issue if no symptoms are accompanying it and the response to exercise is certainly reassuring.
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Would you be so kind as to point me in the direction of a case study, or a discussion group, for a person like myself. I live in a very rural part of the US and both my primary doctor and cardiac specialist have not seen someone like me before. I am a 43 yrs old female, over weight but moderately active, with very high BP, 3rd degree AV heart block, with a pulse between 32-42 resting and exercising pulse of 45. Non symptomatic, but I try to avoid exertion to be on the safe side.
All the doctors can suggest is pacing, which I am against. Are there cases of people like me who are not in the normal range, who did not get a pacemaker, and who lived long enough to tell about it?
You should see an electrophysiologist for evaluation. The question is what level of the conduction system is the block in and what is the danger of it degenerating in to an dangerous rhythm. Its not about being against pacing, its about making sure it is only performed when strongly indicated. The heart rate itself isn’t the issue here, the degree of block and the conduction system disease is the issue.
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Thank you Dr. Mustafa for your response.
I am 31 years old male, sometimes when I stand up I feel I will faint. I went to a doctor and they found that my heart rate is low (42) ” I am not athlete”. Then they provided me with a heart monitor holter for 24 hours and the lowest beat was 36. I did MRI for the heart and it was Normal.
Please advise.
Regards
Mohamed
Have you had a 12 leak EKG? was it normal? also it may be advisable to perform an exercise treadmill to assess heart rate response. You should measure your blood pressure when you feel faint also to see if that is possibly contributing.
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Dear Dr Mustafa, firstly thanks a lot for taking the time to share your knowledge with us.
I am a 29 year old male. My resting heart rate is usually in the range of 45-50 beats per minute and has been this way for the past decade (don’t remember checking before that). My heart rate increases when I exercise. I am certainly not very physically fit so no ‘athlete’s heart’ here. I exercise 1-2 times a week and do moderate cardio for 30-45 mins. I have done a thyroid test and the parameters were found to be in the normal range.
Now for the symptoms: I have tried to read up on online about the negative symptoms associated with bradycardia. The words that repeatedly pop up are ‘dizziness, fainting, shortness of breath’ etc. But I haven’t really found much on “milder” symptoms that I experience. Let me give you a few examples.
1. When I am in surroundings where the ambient temperature is below 25 degrees Celsius, my hands and legs tend to get cold. While this may not seem abnormal, I have noticed a marked difference between skin temperatures when I shake hands with most people (this can actually be a bit embarrassing).
2. I generally feel unenergetic and need to push myself to get moving
3. I have trouble concentrating. In fact it often takes stressful situations to get me to focus.
4. I experience significant hair-loss.
5. Most of the time I have shadows under my eyes (I sleep for 7-8 hours a day so sleep deprivation is not the issue here)
6. Although I don’t have frequent episodes of fainting, I have had these near fainting experiences on a few occasions when I have returned from swims in cold water (15-20 degrees) and also when I have consumed alcohol and woken up in the middle of the night to pee.
I’m in no position to come up with theories but my I feel like some of these symptoms stem from poor circulation. Extremities being cold, hair falling off easily, poor concentration all hint at less than adequate blood supply to limbs, skin, head etc. The near fainting experiences also seems like the result of the heart’s inability to pump enough blood under some circumstances.
My question/issue: I do not have any major symptoms that seem to warrant the installation of a pacemaker. However, these and a few more minor symptoms make me feel like I am functioning sub-optimally (both physically and mentally) because my heart won’t beat fast enough. I guess my real question is: will a Dr consider installing a pacemaker if it can improve quality of life, even if there is no strong evidence of pathology?
Firstly i would suggest simple blood tests that include thyroid function testing. It does not sound like the issues you have would be related to a mild bradycardia as you describe. I would recommend a general medicine check up and thyroid testing as the next step. A pacemaker is certainly not indicated at this point as there is no evidence it would affect quality of life. A baseline EKG should also be performed.
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I went to the cardiologist and they put a monitor on me for a week, it came back my rate rates drops to 28 & the highest being 207, my symptoms are light headed, nausea, & passing out. It started during my third month of pregnancy and I am now 8 months post partum and it’s still happening. I have an appointment tomorrow with my doctor to follow up with the results, any idea what he will do?
Hi there… I am 43… female…. and I am disabled… I am mostly bedridden…. I get up to go to the bathroom and get up a few times a day but not too much because I live in chronic pain… I always monitor my blood sugars and blood pressure as I am a type 2 diabetic, non-insulin and today, my resting heart rate was at a 50. An hour later, it was at a 47. I am NOT physically fit, I don’t exercise at all…. in too much pain to do any exercising… …this was the lowest I have ever seen it. I am worried, is this too low?????? I am extremely exhausted… but I have also been up for over 30 hours straight.. and that happens sometimes due to my pain and insomnia… but should I be worried??? I am normally at about 57-60 on average. Thanks.
Jo in NJ
If there are no other associated symptoms then a heart rate of 50 is not a real cause for concern in itself.
My heart rate is usually between 70 to 75 but I went to donate plasma I do it twice a week and I get my vitals checked every time before I’m able to donate but I was unable to donate this past week because my heart rate dropped to 40 a and would not go higher should I be concerned
If it stays low and or causes symptoms then you should probably at least get a basic check up and a 12 lead ekg.
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My wife recently measured her heart rate in the 30’s. It might get to 40 with some activity, but resting it could be 29. When she realized this she decided to go to emergency to have it checked. They confirmed the reading and kept her in the Heart Institute in Ottawa, Canada for a few days monitoring her heart and blood work. Finally she was discharged without treatment except for an anticoagulant apixaban. They said a pacemaker was not appropriate since she did not display any of the usual symptoms for a low heart rate. I.e. she was not fainting or dizzy and her energy level seemed normal.
She is 76 years old and otherwise in good health. Does not smoke, drinks very moderately, and takes no prescription medication. In the recent past, a few months ago, her heart rate was around 60 (resting) which we measure from time to time. So this appears to be a change. And she has some arrhythmia.
So the questions are:
is this a real concern or can some people live without much risk with that low a heart rate.?
If it is a concern what should the next steps be?
It sounds like she has developed a rhythm known as atrial fibrillation hence the initiation of a blood thinner as stroke prevention. In terms of the heart rate if she has been seen by a specialist that is reassuring, perhaps a wearable monitor would be the next step.
Thank you for your response. She has now had a stress test which lasted 6 minutes and her max heart rate was only 100 bpm, and she is wearing a monitor for the next two weeks, and has an echocardiogram scheduled.
Hopefully after these tests there will be a better understanding.
You have been so generous with your time and advice which is greatly appreciated. We are still at a loss to know what the best way to proceed might be, and would very much like your thoughts.
Here are a couple more relevant tests.
Loop Monitor Results
COMMENTS: The patient is a 75-year-old woman with symptomatic dizziness and chest pressure referred for assessment of atrial fibrillation with slow ventricular response. The patient received a monitor with both the atrial fibrillation and arrhythmia autodetection feature. The asymptomatic baseline recording captured atrial fibrillation with a ventricular response rate ranging from 35-40 bpm. Following the baseline recording, 11 transmissions were received for a total of 89 events. Atrial fibrillation was captured on all the recordings with a ventricular response rate ranging from 30-70 bpm and very rare ventricular ectopic beats. Most of the recordings were asymptomatic and automatically initiated by the monitor, and some correlated with chest pain and tightness in the back and in the chest.
DIAGNOSIS: Symptomatic and asymptomatic recordings captured atrial fibrillation with a ventricular response rate ranging from 30-70 bpm and very rare ventricular ectopic beats.
Echocardiogram Results
Chambers
The left ventricle is normal in size. There is normal left ventricular wall thickness. Left ventricular systolic function is normal. The left ventricle is hyperdynamic. The left ventricular wall motion is normal.
The right ventricle is mildly dilated. The right ventricular systolic function is normal. The left atrium is severely dilated. The right atrium is severely dilated. The interatrial
septum is intact with no evidence for an atrial septal defect.
Valves
The aortic valve is trileaflet. The aortic valve opens well. There is mild aortic sclerosis. Trace aortic regurgitation.
There is mild mitral annular calcification. There is mild (1+) mitral regurgitation. The tricuspid annulus is dilated. There is mild to moderate (2+) tricuspid regurgitation.
The pulmonic valve is normal in structure and function. Mild (1+) pulmonic valvular regurgitation.
Great Vessels
The aortic root is normal size. Mildly dilated ascending aorta. Mild atherosclerotic plaque(s) in the abdominal aorta. There is moderate pulmonary artery hypertension.
Interpretation Summary
Atrial fibrillation. The heart rate was approximately 41-55 bpm.
1. Normal left ventricular size and systolic function.
2. Mildly dilated right ventricle with normal function.
3. Moderate pulmonary hypertension.
4. Biatrial enlargement.
5. Mild to moderate tricuspid regurgitation.
6. Mildly dilated ascending aorta.
The concern here would be the slow ventricular response and also the question as to whether there is an inability to mount an adequate heart rate response to exercise. If there is issues with this a pacemaker may be indicated particularly if the dizziness is associated. The atrial enlargement is likely due to the atrial fibrillation.
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I am 41, and have had bradycardia for the last year or so. It has caused dizziness, and I’ve even fainted a couple of times. I wore a heart rate monitor for a month, which showed that my heart rate occasionally dips into the 30’s, but my average resting heart rate is 57. I start feeling dizzy when it gets below 50. 2 years ago, I went through a weight loss program and lost 150 pounds. I did not have this problem before that. It started around the time I reached my goal weight. Over this summer, I have gained maybe 20 pounds (vacation), and my problem has completely disappeared. My fitbit tells my that I’m usually in the 60’s, and I haven’t been dizzy once. Now I’m thinking maybe my weight was a little too low and could have been contributing to my bradycardia. Is that possible? My goal weight was 135, and I’m 5’7″ tall. At 150 pounds, the problem has at least temporarily gone away.
Its not rigorously studied but i have heard of both excess weight associated with bradycardia and also weight loss associated with bradycardia. In those significantly overweight often breathing issues may occur that can stimulate vagal tone and associated bradycardia, much more often during sleep though.
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Hello,
I am a 34 year old male. In February 2017 I was 345 lbs and had an average Resting Heart Rate between 90-100. I started exercising regularly (about 90 minutes a week of rigorous workout) and reduced my food and alcohol consumption. Six months later, I have lost over 60 lbs and my RHR has dropped to about 60.
Sometimes when I stand up after sitting, I am dizzy for a few seconds but it wears off. I find that 4 out of 5 days I need a nap in the afternoon (for about 20 minutes). Today my RHR was at 58. I work from home and my job is sedentary.
At first I thought it was a good thing that my RHR went down. When I saw that below 60 was abnormal, and also that dizziness and fatigue are warning signs, I started to get a bit nervous. I went from eating about 5 full-sized meals per day to 1 and a half (plus snacks of real fruit 2-3 times a day). I don’t know if it’s related and if I should be worried.
A rate of 60 itself is not worrying however your associated symptoms of dizziness warrant the need for evaluation. I would start by going for a basic medical check up that includes an EKG heart tracing.
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I am a 59 year old woman. My heart rate drops to below 40 and sometimes below 30. I feel dizzy and weak when this happens. But my heart rate will then go back to normal and then back down again. Could this be Bradycardia?
By definition the rates you mention are bradycardia, my concern is that you may be having some form of heart block, you need at least an EKG, likely a monitor, and medical evaluation.
If you are interested in information and therapy for heart disease then feel free to follow my twitter at @MustafaAhmedMD
Thank you for the information.
If you are interested in information and therapy for heart disease then feel free to follow my twitter at @MustafaAhmedMD
I’m just 21 years old and when I wake up in the morning my pulse rate stays 50 per minutes and when I walk then my pulse rate stays 75/85 per minutes… You know,I’m not a athletic…I did the ECG and echocardiogram and it was fine..The doctor told me that I have no problem…so tell me what I should do???
The heart rate alone without symptoms is not necessarily an issue and it sounds like your tests worked out just fine so there is likely no cause for concern with regards to the heart rate alone.
I have had postural tachycardia for 5 years managed with super low dose atenolol – just 8 MG a day. I have a history of vertigo as well as chest pain and breathing issues with costochondritis. Recently my resting heart rate has fallen from the 60s to the low 50s. My blood pressure was 100/70 and now it’s 120/80. I did a stress test and it was good even though my chest muscles were sore. I am concerned about AV block. I had an EKG but I was nervous when it was taken and my heart rate was higher. By the time I got to my car was low again. If I had AV block would it have shown up on the EKG even though my heart rate was higher at that moment? Thank you.
Sounds like to answer the question you will need at least a 24 hour monitor such as a holter monitor. The EKG with the normal rate alone may not show it. A resting rate in the low 50’s in itself may not be any issue whatsoever.
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My resting heart rate is normally in the mid to high forties –often going as high as 52. However, I have noticed that I have been having a lot of drops —today it went to 36 while I was awake and sitting. I seem to be having a lot of ups and downs –bouncing from 50ish to mid /high 30’s. Sometimes I notice that I just don’t feel right (can’t pin point what’s wrong ) and will look at my garmin and my rate will be in the 30s. I’m not super active–run 3 days a week for 30-60 minutes and get an average of 15k steps on my tracker daily. Should I make an appointment to things checked or am I being paranoid?
How was the 30 being measured? Some of the new fit bit type accessories can give unreliable readings. If by manual confirmation then 30 is pretty low. Its reassuring that you done get symptoms such as shortness of breath, passing out etc. I would say that it is worth going and getting at least a 12 lead EKG to ensure it is normal at baseline. Since you don’t feel right at times, i would advise a medical check up where the EKG can be cone at the same time.
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My 22 year old son was diagnosed with bradycardia and his electro cardiologist told us that he has chronotropic incompetence but he has never seen this is a 22 year old. Have you ever seen this is a person that young?
Technically it can happen at any age however it is not common in younger people and usually much more common in the elderly. Chronotropic incompetence basically means that the heart rate does not mount an adequate response to stimulus such as exercise. For example in normal cases the heart rate rises with exercise or walking etc, in chronotropic incompetence it dies not rise adequately.
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I’m 25 and exercise rigorously about twice a week would not call myself an athlete by any means now but 5/6 years ago did used to exercise hard 4/5 days a week. My resting HR sitting behind a desk is usually just below or above 50. Is this something to be concerned with? Apart from a heart murmur when I was a child and anxiety attacks I feel ok. What symptoms or signs should I be concerned about?
50 is not particularly low. Symptoms of a low heart rate of concern would be fatigue, dizziness, passing out, shortness of breath etc.
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Hi. My partner is 49 years old has been suffering with shortness of breath over the last 9 months and feeling tired..He also had an episode of fainting 2 years ago which may be related also.He has been to doctor this week and was referred to hospital for tests. chest xray and ecg were fine. They were concerned about his heart rate (resting heart rate 40). unfortunately further tests echogram & stress test have a waiting list of to take up to 2 months. would you advise going private to get seen to earlier as he seems to to have symptoms similar to bradycardia?
If there is presence of dizziness, passing out or development of unstable symptoms you should likely expedite the work up, if not and the symptoms are stable the wait may not be an issue although it is incredibly frustrating, its reassuring that he has been seen by a medical practitioner who felt this was ok.
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Hi Dr Ahmed,
Thanks for the great work you do! I’m sorry for troubling you with my question.
Iam a 35 year old male and for the last few years I occasionally wake in the night suddenly white my heart racing and cannot breath, I feel like I am dying and it is a terrible experience. I have more or less come to live with it as my doctor said it was anxiety. my wife recently bought me a heart rate monitor watch which I wear during my sleep. My resting rate is around 45 I’m not concerned as I’m a very fit endurance athlete. However after waking suddenly after a funny episode I looked at my heart rate on my watch and it had fallen to 32 during my sleep which is when I awoke suddenly. Feeling like I couldn’t breath. It appears that my heart rate falls this low on most nights but I don’t always have s funny episode.
Should I be concerned??
Many thanks
John
The next step is to wear a monitor, likely starting with a holter monitor to characterize the heart rate and rhythm during these episodes. Heart rate commonly falls at night and in the absence of symptoms is no cause for concern. Since you have some symptoms i would go ahead and start with a monitor, if anything for reassurance sake.
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Hello dr my heart rate always be 40 to 48 when am rest and on sport it increase to 90 to 120bpm sometimes in the morning it can be 25 t0 30bpm i have done all the tests ask by the dr but my dr didnt want to fix pacemaker i am 31 years old
Hi Dr. Ahmed!
My mother treats her afib episodes with extra beta blocker dosage, and then takes salt water to bring her blood pressure back up. Her heart rate also goes very low and she’s afraid to fall asleep because her rate might go too low.
Is there any technology available to consumers that will monitor her heart rate and sound a loud alarm if it becomes dangerously low. She wants someone to talk to her so she doesn’t fall asleep. This is not always possible and sustainable long term . THERE HAS TO BE A SOLUTION. Please please help us.
Thank you!
Her specialist can very easily prescribe a long term monitor to characterize the heart rate and to see if there is an indication for pacemaker implantation which there may be.
If you are interested in information and therapy for heart disease then feel free to follow my twitter at @MustafaAhmedMD
Please help me. I recently had a stress test done on the treadmill. The Cardiologist said my heart rate is not going up enough and my blood pressure is not going up at all,but he doesn’t k ow what is causing it.Any suggestions?
Do you have more details of the treadmill report.
I’m 33 year old male about 160 pounds. For several years I’ve had a low resting heart rate usually in the 50’s. The last 3-4 days I’ve felt unusually sluggish and drained. My heart rate has been lower then Normal in the 40’s. I woke up in the middle of the night and my Fitbit said 36 bpm. I’m just freaking out about the low heart rate. I also suffer from anxiety so this isn’t helping. Im not on any mess. I started working out a month ago 3-5 days a week. I’ve also been a smoker for 10 years. Quitting now. The past couple days I feel almost like energy levels are spiking up and down. I work late nights 5 days a week. Could anxiety and bad sleep habits lower heart rate even more?
I would recommend you go see a healthcare provider and have a basic check up, physical and EKG for starters. Heart rate can certainly drop over night. See what your check up and EKG shows and go from there.
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If you are interested in information and therapy for heart disease then feel free to follow my twitter at @MustafaAhmedMD
I am a 54 year old male in excellent shape. I go to the gym 5 days a week, running and lifting 3 days and playing competitive raquetball 3 days. Last week I noticed shortness of breath going up a short flight of stairs and then could not run over a minute on the treadmill at a 6. I normally do a 10minute warm up at up to a 7.5. This shortness of breath and occasional light headedness has lasted for over a week now. I noticed on the treadmill despite the shortness of breath I had a low heart rate of 79. Any thoughts?
You have had a significant change in exercise capacity and this warrants evaluation. I think you should seek medical evaluation. From a cardiac standpoint a treadmill exercise test and or other tests may be a good place to start.
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If you are interested in information and therapy for heart disease then feel free to follow my twitter at @MustafaAhmedMD
Hello Im 17 years old and I just had an ECG (electrocardiogram) yesterday and my heart rate was only 50 bpm. And I am no athlete. My concern is, if this is normal or do I have some complications or anything ?
Most likely normal, if you are concerned then go for a routine check up with a primary care physician and have them look at the ekg.
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If you are interested in information and therapy for heart disease then feel free to follow my twitter at @MustafaAhmedMD
I’m a 55 year old female who is 50lbs overweight. All of my life, I have had a slow heart rate with no issues. I wore a 24hr holter monitor and the cardiologist said 100% pacemaker required. I’m having the procedure within a few days. I have been extremely fatigued, lightheaded, dizzy and nauseous. I’m now having chest pains. Are chest pains included in the symptoms of bradycardia requiring a pacemaker?
The chest pains are possible with a very low heart rate although not common like fatigue, dizziness, passing out and low exercise tolerance. The chest pains should be evaluated by the treating physician before they are simply attributed to bradycardia.
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If you are interested in information and therapy for heart disease then feel free to follow my twitter at @MustafaAhmedMD
Hi doctor , i wanna ask about my heart , once im gonna take an operation cause of accident , but every time i go to the operation my heart is down to 38-39 beat per minute and the doctor will give some injection i dont know what it is but even the third time they give that injection my heart rate only go to 57-58 beat per minute and wil never go above 65 beat . And then the doctor canceled the operation 3times because of my heart rate , but if im not in the operation room my heart rate will go to 65beat per minute. I wanna ask why is that ? Can you explain why is that ? And im not a well-trained athlete . And im a smoker and recently drinking alcohol many times. (Sorry for bad english) please reply thankyou doctor.
Sounds ridiculous and frustrating that an operation has been cancelled 3 times due to this. The drop in rate is likely a vagal type response. Regardless, a clearance would generally be required from a cardiologist who can rule out underlying abnormality and potentially be on hand in the operation and communicate with the anesthesiologist.
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This was so interesting, with so much information Just wanted to say thanks for your helpfull information. Thanks so much
Thank you for your feedback,
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If you are interested in information and therapy for heart disease then feel free to follow my twitter at @MustafaAhmedMD
I’m a 21 year old male, and I had to go to the emergency room on Sunday due to nausea, vomiting, dizziness, chest pain, as tightness. And for the past few years my heart rate is between 35-50 bpm during the day no matter what I’m doing and 150 bpm while I’m asleep (I was put on a heart monitor before) I’m not athletic at all besides running around at work. And my doctor said that was normal at my age and weight it just worries me cause I can feel when my heart rate drops to below 40 my heart starts to hurt and I can’t breathe is that normal ?
Have you seen a heart specialist, this sounds to me like the next logical step and will at least be reassuring even of no significant abnormality found.
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If you are interested in information and therapy for heart disease then feel free to follow my twitter at @MustafaAhmedMD
My heart rate can drop to 55 at rest and even lower when in bed. I often feel very weak in the knee and disturbing tingling of scalp, arms and legs. The heart rate seems to rise very fast and loud and can reach low 90s in a very short time. When the HR is low the BP can reach 160/90. As the HR climbs, the BP does drops most often without mess. When I take Toprol 12mg, HR can stay in low 50 for 12 hours with terrible crawling skin.This up and down movement is the order of the day. This phenomenon started with a pregnancy 6 years ago. There is a visible pulsation at the base of my throat which fluctuates in rhythm with my heart. I have had extensive medical evaluation with no resolution. Been to Mayo. Heart monitor, EKG, Renal study – all good. Please weigh in. I also take Lisinopri, HCTZ as needed. I take my BP when I feel symptoms.
Hi Dr
ive had over 8 years sinus tachycardia with rest heart rate 80 with taking beta blocker and bp 130/90 recent 3 years and after stressful life plus many times left sided heart pain 2-3 second like needle , my resting heart rate now is low 60’s bp 110/70 without bblocker, after blood works , ekg , stress test , echocardiogram , holter 48 with rare junctional escape beat and my lowest number was 42 highest 140 all results was normal but still i have fatigue .
my Q
it could be i suffered from old heart attack in the past and those tests above cant determine that ?
it could be depression and some neurotransmitter should be altered by pills and that could affect my heart performance and well being ?
it could be sinus node dysfunction ?
Thank you
The question as to prior heart damage can likely be answered with an echocardiogram.
The medication can contribute to heart rate on some occasions and should be reviewed by your physician.
The EKG at baseline and the holter monitor should answer the question about sinus node dysfunction.
Discuss these points with the treating physician reviewing the tracing.
Hi Dr Thanks for help
im not on any beta blocker medication now i used to take it for 4-5 years
i haven’t taken any ssri snri medications
my GP request me to take ssri or snri pills
my last Q
48 holter sinus rhythm and rare junctional beats specially in supine position [i felt that like a strong beat]
plus 15 isolated pacs
no other ectopy or pause
ekg sinus rhythm normal
stress test was normal
could snri or ssri sometimes help for heart disease patient ?
Thank you
So I’m 21 and I was told I have normal variant heart rate. When I’m relaxing on the coach and just hanging out my heart rate is about 50-60 and when I go to sleep it goes to 40-60 I have been told by my eco that my heart is pumping fine and everything is closing fine. I’ve been to a cardiologist and he said this okay for my age. I don’t believe I have any symptoms but I’m just worried about it and want another opinion.
If you dont have symptoms, and you have a normal ekg and have even been checked out by a physician then you can likely be reassured.
you can follow my twitter at @MustafaAhmedMD
I’m 40, but consider myself pretty healthy. Kinda crappy diet, but I ride my bike to/from work, play hoops and tennis when I can. Work out in the basement a couple times a week. I experienced a day with dizziness and what I thought were chest pains. Went to the ER, and then over the next several weeks, I had many tests thru a cardiologist. Resting pulse was about 48, which I think explains why I sometimes get light headed after standing up too quickly. Wore a monitor….dipped to 30 bpm at night. Passed a stress test. Think my episode that one day was due to dehydration. I had helped a buddy build a handicap ramp the day before, and we had no water or food, just a lot of beer. 🙂 And it was very hot that day, and sunny. Needless to say, I won’t ever do that again! I try to drink a ton of water now, and now I have no issues. Pulse is still in 40’s and I try to stand up more slowly now. I tell my wife I have an athlete’s heart/pulse. Haha.
It up to you of course but if you aren’t comfortable with the opinion you have it may be wise even if simply for reassurance. In the absence of symptoms, with normal testing, and appropriate heart rate response, its likely there is no significant issue.
you can follow my twitter at @MustafaAhmedMD
I used to have a resting HR of 38 and it made sense because I did ALOT of cardio… my cardio has decreased substantially and HR has gone up to about 44. But still at night, during a recent monitoring of my heart, it went as low as 31. I think checking adrenal system and thyroid is good. I’ve also been reading something about sleep apnea and low heart rate. I have morning headaches alot, and that is also associated with sleep apnea. May check those out, too.
Hello Doctor.
I am 19 years old and my heart rate is mostly around 44 and 49 beats per minute. This is accompanied by Shortness of breath, excessive fatigue and confusion. I am by no means an athlete and I don’t do much of physical activities.I first noticed this a month ago when I had shortness of breath and sharp pains in my chest every time I inhaled air. I went to see a doctor last week and he carried out blood tests which came out clear. An ECG was also carried out and it showed that I had irregular heart beats, he then (first doctor) referred me to a cardiologist who also performed an ECG on me and it reflected the same thing and he also did an Echo-cardiogram and he said that my heart was fine and that there was a valve which didn’t close completely but instead bends. He prescribed that I take EMFORAL(Propranolol) 20mg everyday and I’ve been doing for 5 days now.
I’d like to know if this is serious or not.
Thank you
What exactly did the echo report show?
Well the doctor said that my heart was normal and healthy, but there was a valve which didn’t close but bent, this valve is in my atrium, I’m not quite sure which one it is and I’ve been getting pains in my chest which last for a few minutes. At first I thought that they were caused by my bra being on for a long time but now I realize that that isn’t the case because I still get them even when I don’t have my bra on.
Can you help me out doctor? I had a pacemaker implanted, pulse is 60 per minute. Isn’t that too low? I don’t smoke, I am a moderate exerciser 47 years old. Sometimes after walking 3-4 blocks I have intense chest pains and can’t raise right arm. Also just a little dizzy. Feels horrible.
My guess is my pulse is too low. It should be in the 80s range. What do you think? I could use a good theory, even a guess.
I do have sleep apnea (mild), had a type II aortic dissection no surgery and I am taking high blood pressure meds.
Depends why you had the pacemaker. If it was for heart block or bradycardia then it seems the pacemaker is working at a back up rate of 60. It is reasonable if symptomatic to have it interrogated when you see your dr to ensure there is appropriate rate responsiveness. The chest and arm pains are not likely related to the heart rate and i suggest you have them looked in to.
you can follow my twitter at @MustafaAhmedMD
I have pacemaker. Yet my pulse is still a consistent 60 beats per minute. Shouldn’t it be higher.
I agree that 60 to 100 is normal, but I get tired easily from walking (lower back pain).
I do have other problems, type II aortic dissection and sleep apnea sleep machine cpap use.
I still believe the pulse is too low.
I just fainted last week and when I was admitted to the hospital my heart rate was anywhere from 40-47. It did go up to 50 right before I was discharged. They did EKG, echo, I had a stress test 2 weeks ago, my potassium was in normal range. My typical rate is around 65. They cannot find anything wrong. I have a follow up appointment next week to get my stitches out of my face from fainting. Any suggestions or specific questions I should ask my doctor and/or cardiologist?
Sounds like they have things covered from a heart point of view. Would certainly recommend consultation with a neurologist.
you can follow my twitter at @MustafaAhmedMD
My heart rate is never over 55. It usually goes down to 40-45 at night time or upon rising from naps. I do exercise a good bit and watch my diet. I’m 30 years old, I haven’t drank alcohol in probably three years, very limited caffeine (definitely no coffee), flax seed and raisin bran for breakfast every day; etc. I used to workout in the morning, swim mid-day, and do yoga. It’s all contextual. So technically speaking, I have bradycardia, but pathologically speaking I’m most likely fine. Remember, it’s patients not numbers. Lance Armstrong had a resting heart rate of 32 in his prime. There’s no way any medical professional — or anyone else for that matter — will ever convince me a resting heart rate of 100 is normal or good even though it’s within the standard 60-100 range.
If you’re overweight, never exercise, and have a heart rate in the low 40’s-low 50’s, then there maybe an underlying issue.
Dr. Mustafa,
I’m a 68 year old male with high blood pressure that is being treated with 100 mg Lopressor and 50 mg of Losartan. I also have a LBBB. Recently, say the last 2-3 weeks I’ve been feeling light headed and more recently blacked out/fainted momentarily on two occasions. My pulse was low and erratic when this happened. Is it possible to incur side effects from the meds after taking them for several years with no previous ill effects? I made an appt with a cardiologist for next week (earliest I could get). Unfortunately, I’ m working out of town for a couple more days in an area without much medical support. I contacted my GP and she said to get my dosage but wasn’t specifc in what regard.
I read with interest your article, wondering if you have any good input.
Thank you,
Fred
Sorry, reduce my dosage.
See what your evaluation shows, a baseline ekg is needed and likely a monitor that is wearable. The lopressor likely needs changing also.
you can follow my twitter at @MustafaAhmedMD
Dr mustafa
I had a pacemaker put in a year ago for passing out. It’s just there in case my heart rate drops too low. I haven’t felt good ever since they put it in. I never feel good. My heart rate is always low. At night I feel the worst. That’s when the rate is in ghe 50’s. I feel dizzy and anxious and short of breath. I don’t know what to do. No one will take the time to help me. Please help!!
start by having your pacemaker interrogated to see the frequency of pacing to ensure its appropriate, and also to see if symptoms are correlating with the pacing, if so some setting changes may be suggested.
you can follow my twitter at @MustafaAhmedMD
I’m 54, about 30lbs overweight and have been having palpitations for 3/4 months. Went to docs and had ECG. Was diagnosed with bigeminy and advised to stop caffeine immediately. My pulse was taken and it was 44. A week later and it’s 44 (sometimes lower) and I don’t feel great, although that may well be the anxiety circle!
Any thoughts gratefully received.
Dr. Mustafa. Question about heart rate variability. Had OHS a yr ago. Aortic Root replacement, resuspended aortic valve, ring on mitral valve. HR pre op was resting in 50s. Now rests in 30s. Asymptomatic. When I wake up at night it is in 30s. By the time i walk to restroom 2 rooms away it’s in 70s. Is this too much of a quick increase in HR? Overtime, could this significant increase cause cardiac event? Do I need to tell doctor? Also can low heart rate cause heart failure or LVEF dysfunction? Thank you.
Its not an issue that it rises to 70 so quickly, rather its an issue that it is sustained at 30. I would recommend an EKG and potentially a monitor, also a treadmill test to characterize the rhythm and ensure no heart block. In general, unless an abnormal rhythm, low sinus rate should not cause failure unless its so low as to not perfuse the body but that would be symptomatic.
you can follow my twitter at @MustafaAhmedMD
Hi Dr. Ahmed,
I’ve been experiencing palpitations (daily a few times) (feels like a pause then a hard beat). Also have occasional episodes when my heart will race for no apparent reason. Occasional feel short of breath. Ankles seem swollen some evening. Sometimes I get a head rush after feeling the palpitation.
I am 39, female. 5’6″ 156. So a little overweight. Don’t exercise as much as I should.
Have been to er a few times for these symptoms.
Ekg always come back fine – always normal sinus rhythm with sinus arrhythmia.
Wore an event monitor for 2 weeks this spring and again for 3 weeks in August. Cardiologist said nothing on monitor (I felt palpitations daily when wearing). Had echo – results were fine on that also. No valve issues. Etc. my blood pressure is generally around 110-70. Sometimes 90’s/60s. Heart rate at rest while awake seems to be in 60s mostly. I don’t take any medications. Don’t drink anything with caffiene. Don’t smoke or drink.
All drs say this is just anxiety. But I can FEEL the heart palpitations.
Can anxiety cause them? Do you suggest any additional testing?
Its reassuring that your testing is basically normal. I realize its frustrating and you have symptoms but it may not be a cardiac issue particularly if the heart rate or rhythm was not abnormal despite you being on a monitor and feeling the symptoms. You could have someone else review the monitor, or repeat it with a meticulous symptoms diary to correlate. In some cases a trial of beta blocker may be warranted.
you can follow my twitter at @MustafaAhmedMD
Is it possible to ask questions to specialist of your web site?
I am 41,male.I was diagnosed for high bp 220 /120.18 months ago, I was stabilized and placed on atenonlol and Vasoprin. I did ecg and echo where tachycardia,ocasional/frequent arterial premature cum referred to as abnormal, another ecg suggested hypercleamia while echo reads concentric LV chamber hypertrophy,LV apical hypokinesia.This they say is compatible with hypertension with feature of LV apical ischemia.I have been taken the atenonlol but I have extremely weak with occasional pressure on my chest pain that radiate from chest to arms and legs, shortness of breath, low pulse rate after taking the drug for a while but tiredness without any strenuous work, sour throat feeling. dizziness,tingling,numbness of arms and legs are my symptoms .But my cardiologists just suggested use of the drug with moderate exercise.What do you suggest I do
Have you had any form of stress testing?
If you are interested in information and therapy for heart disease then feel free to follow my twitter at @MustafaAhmedMD
I’m a 43 year old female. I am overweight and do not exercise. I work full time in front of a computer. My RHR is normally 53bpm but it can go as low as 46bpm (which it is just now). I suffer from migraines and have recently been prescribed propranolol as a prophylactic. I’ve never had an EKG. I am often dizzy even when just sitting still. Once in a blue moon I might feel a hard beat of my heart but nothing other than that. Is this something that could be normal for me or should I mention it to my doctor?
If your resting heart rate is low already, you have symptoms, and you have been prescribed propanolol a baseline EKG should likely be performed.
you can follow my twitter at @MustafaAhmedMD
My blood pressure was going up, and my Doctor put me on lisinipri, which caused a bad cough. Then I tried Losartan-Potassium, which caused severe diarrhea for days on end. I quit that. I just started taking 25 mg Atenolol. Now my bp is like 158/72, and pulse has been 49 to 53 average. One day I felt very faint and a bit dizzy. Should I keep taking Atenolol? The Pharmacist told me I’ve taken 3 of the 4 classes of blood pressure drugs. Only one left. I’m worried about fainting. I’m a female, age 72. I also have Elher’s-Danlos syndrom that has damaged my shoulders and feet and ankles and low back.
With those symptoms you should see your healthcare provider for sure. Atenolol is not an effective BP agent and will also lower the heart rate. Maybe discuss amlodipine, spironolactone and other such agents with you provider.
you can follow my twitter at @MustafaAhmedMD
I am a 43 year old female , don’t do exercise, I weigh 176 lbs. My pulse is at 54-56 bpm. I have been experiencing problem sleeping at night, chest heaviness , I don’t have respiratory obstruction but feel as if have to take deep breaths. I fatigue easily and have dizziness at times even on resting. Please advise.
See a physician, get a basic check up that includes physical exam an EKG and to see if further testing is requires to rule out a serious cause of your symptoms.
you can follow my twitter at @MustafaAhmedMD
Hi. I and 19 years old female and was diagnosed with anorexia in may last year. I am in no way active really. I experience tightness in the chest area, breathlessness and dizziness especially when I stand up I walk for a while and I can’t really see infront of me it’s just black. The chest pain happens more when I’m extremely cold or walking. The chest pain occurs more frequently if I’m having a ‘bad patch’ or haven’t eaten for a period of time that day (few hours). My resting heart rate is 48 bpm. Should I be worried?
Although there may not be cause for concern you should see a Dr to discuss the symptoms, and have a basic check up and work up.
Hi I’m 21 years old and I have a resting heart rate of 25to 35 when I sleep and when I’m up my heart rate is 45 to 50 I’m not vary active I walk about 3 to10 miles a day and play b ball once in a while and I’m 6 foot 5 so ya is that normal
I doubt the 25 is accurate, how was it measured?
My father is 78. He has had a pacemaker for 5 years. The pacemaker is working. But his heart is becoming more dependent on the pacemaker. He now has a low resting heart rate around 30-35 bpm. Was causes this? What are the treatment options?
The pacemaker is there as a back up so even if the resting heart rate drops low the pacemaker will kick in. The pacing checks will tell you how often this happens. Its likely progressive conduction system disease. The treatment is already there, the pacemaker.
you can follow my twitter at @MustafaAhmedMD
I’m almost 40 and have had some health issues recently. What’s actually happened is I’ve gotten healthier and then symptoms showed up. Dizziness, lethargy, BP dropping to 80/55, and heart rate in the low 50s. I was on Lisinopril to control BP prior to my weight loss and cardio regimen and my doctor took me off of it. However, it’s now been almost 6 weeks since my last dose and those symptoms still persist. My heart rate is “normal” on some days, not dropping below 60 unless I’m asleep, and then days like today it will drop as low as 48 while I’m sat in front of the computer. What really confuses me about that is that my heart rate is actually higher while I’m asleep, in the mid 50 range, than when I’m awake but inactive. I’ve had two ECG’s done which don’t show any issues but haven’t had a stress test or any sort of medical heart monitoring done. My doctor knows all of this but he hasn’t recommended any further testing. I’m not sure what to do at this point because the random bouts of dizziness and fatigue are draining and panic-inducing.
If you are concerned, you can seek a second opinion regarding your unexplained symptoms, while the heart rate itself is not overly concerning the random bouts of dizziness and fatigue may warrant further investigation.
you can follow my twitter at @MustafaAhmedMD
Here’s where I am this Christmas morning. I just took my wife to work and she has a Medtronics pacemaker put in 10 years ago and for the past month she has been having most all of the symptoms and her heart rate has gone from 60 to 40. She is fearful of going to the doctor again because she is very athletic and very much against medicines. Also, she flat lined during first implant procedure 10 years ago and that still sticks in the back of her mind. She is convinced that she can improve her heart rate through diet, exercise and supplements. We have done a ton of research, but I would like to know your thoughts on the best supplements, foods and exercises. Another question, we have Reverse Osmosis water at our home and a full home water softener. I’ve been reading where RO water can actually be bad for you and also I was told to use potassium instead of sodium the the whole house softener for the brine tank. Should I go back to sodium instead? She is doing better this week since we started taking Co Q-10 and Geritol liquid, a half an aspirin and 4 oz of Emergen-C. She is 61 and I am 62. Her shortness of breath is getting better and she has not had a dizzy spell in over a week. We do regular short exercises like stretches and tossing the 10 lb medicine ball 2-3 times a day mixed with walking 30-40 minutes and light weight training. What are your thoughts? Thank you so much.
Hi doctor,
My heart rate is 49 BPM , is it safe to take Valium ?.
Thank you
That needs to be determined by the prescribing physician.
Alright thanks , because i have tremor , and i don’t know what i have to do , i wloul like to know if i can take the beta blockers
I am 27 and this past year have made some big changes from a diet perspective and have noticed alot of change in my heart’s function. I cut out all stimulants soda, alcohol, caffeine etc. All grains and dairy and have been eating very strict Paleo now for awhile. As well I have upped my Omega intake with a very high quality fish oil. Rhr has dropped from 80-90s down to 60s. The biggest change I have encountered which is a bit difficult to explain is that before this change at rest I could presently feel my heart beating in my chest without putting my hand there my heart even during excerise would pound which I always thought to be normal. Now at rest I cannot presently feel my heart beating ever and when I do put my hand on my chest it’s such a gentle beat. My main reason for this post is perhaps to ease my mind I do suffer from bad health anxiety which is off considering how healthy I am but I have terrible sleep problems because I constantly check my pulse because I get scared and can’t feel my heart beating like I used to I know how odd I’m sure this sounds! Just looking for an opinion or a explanation as what my heart feels like now is actually normal and healthy. Thank you
Most people do not feel the heart beating at rest or when a hand placed over it. That specifically isn’t typically used as a medical sign in otherwise normal patients.
you can follow my twitter at @MustafaAhmedMD
Hi Dr, I have acid and severe bloatness and my heart rate i noticed that its around 53but doesnt always stay there. I also had panic attacks before and prompted me to see a cardiologist and told me everything was normal. i used to go to the gym alot but now ihavent gone for 2 months due to the panic attack. i am 30 years old and recently had a few beers with my cousin late night and ate some spicy soup. the following morning i had a bad gas and i felt like i was going to throw up then all of a sudden i had an ectopic heart beat. this by the way triggered my panic attack again and was not able to eat the whole day which led me to have acid reflux now. i did notice my heart rate got slower due to this. i am wondering if my vagal nerve is the reason why that is. i have read that the vagal nerve which is also in our gut can trigger premature beats if irritated especially if one has too much going on in the gut such as severe gas or acidity. i also had notice that this premature beats only happens when i burp the following morning after having around 3-5 beers or feel like throwing up after i eat too much or eat lots of spicy food which is rare but. also if my stomach has something to do with my bradycardia.
Its good that your cardiologist felt that your heart was not the cause of symptoms, i’m not sure of the testing done but i’m assuming it was normal and appropriate. The next step then would be to modify your diet and avoid behaviors that trigger the acid reflux and symptoms and also maybe seeking treatment for the symptoms.
you can follow my twitter at @MustafaAhmedMD
I am a 62 yr old female. I was getting palpitations a lot and sometimes with chest discomfort. Echo was good. Several trips to the ER and they find nothing wrong. One time they caught PVC’s. Went for a stress test and when I finished, I went into Afib. Had a cath and the LAD was blocked 95% so I got a stent. Afib went away. PVC’s continued. Holter monitor tests all looked good. Had a Lexi-Scan and it was good. One time the PVC’s were coming every 2 beats so I was admitted overnight. Started a beta-blocker. Also on a statin and baby aspirin. Still feel some PVC’s but not as much. Chest discomfort occasionally. Now my resting heart rate is in the 50’s all day and 40’s during sleep. Systolic BP is fine but diastolic is low, in the 40’s and 50’s. Is this OK? Also taking a small dose of Zoloft in case this is anxiety. Just worried about the diastolic rate and the heart rate.
The heart rate of 40 or 50 alone is not an issue if the rhythm is normal and there are symptoms. Sometimes PVC can cause the heart rate to appear low on monitors. The chest discomfort you have should be mentioned to your cardiologist, it may be that your meds need titrating or further testing done.
you can follow my twitter at @MustafaAhmedMD
Hello, I am a yr old female dealing with RLS/other issues, including Raynaud’s. On 100 mg Metoprolol. I only take 75 mg as I have been having episodes of my pulse dropping into the 40’s with exhaustion,chest pain,etc,my pulse will come back up at times when I am sleeping in the 70’s and I am trembling and sweating. Doc says it is anxiety.With Raynauds, beta blockers are usually not prescribed, correct?Doc says it is also to help with tremor/anxiety. I get very cold also.Had tests done 2 years ago and was told I have a healthy heart, What do you suggest when your Primary doc will not listen to you? I am in a location where Drs. are hard to find. Thank you!
If it would reassure you, travel a distance and seek a second opinion.
Hi doctor I am 29. I did an ecg,blood test everything came out fine but I get pain in the upper left side of the chest. My heart rate usually remains the same no elevation. What could be the cause of my pain? Also I have a heart rate of usually 60- 69, I use to play sports now I don’t anymore, I got in an accident where I was struck in the left side of my chest by a truck when I was 11. So I am asking can u tell me what can be causing my pain thanks in advance
You need to be evaluated by a Dr to ensure the pain is not of a concerning nature.
I’m in my 30’s, female, and a well trained competitive endurance runner and cyclist for many years. When feeling well I am briefly able to get my HR up to max which is around 185. I am able to keep a sustained effort at only slightly below this. I know how this is supposed to feel, and usually do not use a monitor, but do check it periodically with one. My resting heart rate is in the 40s and perhaps lower when fully asleep. This is usually not an issue, just normal for me. However there have been times when it has dropped this low in the middle of the day and I suddenly feel off. I sometimes get numerous palpitations, although these have decreased since I began taking more magnesium at the advice of a doctor. I often get dizzy when standing up too fast, and notice that my HR increases a lot, although BP is stable. Again, normal for me and something I have learned to live with. What is bothersome is that I often have episodes of extreme fatigue, not associated with overtraining, as they occur mostly in my off season. I am having one such episode now, where I feel I am heavily drugged. I also seem to have fluid retention during these episodes. I checked my heart rate during a short workout tonight and at only 150bpm I felt like I was at my max and got very dizzy. I have mentioned these episodes to my doctors. I’ve had multiple EKGs and had a stress test which showed nothing unusual–although I feel like the doctor did not allow me to stay near my max long enough. I’m thinking of trying a holter monitor. My main concern with all of this is that I had a severe episode of what I believe was angina during a run last year. I felt great until it hit, then it brought me to a dead stop. I thought I was having a heart attack it was so severe, and did not try to run again for several days. I’ve had episodes of stabbing chest pain since well before I was an athlete, but never this bad. Does it sound to you like it is worthwhile to keep searching for a doctor or should I assume this is all benign since it hasn’t killed me yet?
Given your exercise ability its probably benign however if you have a stress test i certainly agree its not useful if you cant approach your max. A holter monitor certainly appears a reasonable approach to characterize the episodes of fatigue and concomitant bradycardia.
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Asalam o alaikum sir,i am 28 years old a few months ago my heart beat was suddenly high 110 resting and i used to take an inderal during the using of inderal my blood pressure was also high 160-110 then the doc advised me to take Dio plus 5/80 after the 5 dose of D plus my blood pressure suddenly down to 90/60 and pulse rate 61 beats per min .all the tests ekg ecg rfts cholestrol are normal .now a days my blood pressure remain 100/60 tp 110 and my pulse rate 60 per min in resting when i standing or eating heart beat increase 40 t0 50 beats per min so should i worry about this situation?
Hi Kristen,
Just wondering did you reach any conclusion to youre issues? Very similar to myself,
Thanks
I’m a 69 year old male who recently discovered during routine tests that my heart rate is 40. A successful stress test and visit to a cardiologist who gave me a 48 hour heart monitor showed no pathology. Recently, when talking with my 95 year old dad, I learned that he was not accepted for the draft because of low heart rate and that his mother (who had 11 children and lived to 105, bless her heart) also had low heart rate and was known to have chronically cold hands, a symptom I share.
Hello doctor and thank you for your answers.
I´m 34 male in general non-active but within normal weight (BMI 24). My blood pressure averages 135/85 but it goes up and down all day. I have noticed that my heart rate in the morning is usually between 56-60. In general during the day it´s around 64 and with activity or stress it increases to around 70. I have done EKG and echocardiogram and all was normal. Do you think that heart rate is normal? Thank you
Sounds like a normal range heart rate.
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Hello Sir, I am 64, pre-diabetic H1C = 6.2 and in decent physical shape 5′-11″, 180 pounds. I had a heart blockage with stent placed about 14 years ago. During the day I usually feel fine but at night I get a loud whistling in my ears and when I check my heart rate it’s down around 30 to 40 bpm. No sweating or numbness anywhere. Occasional angina. I played active sports until my mid 30’s. My Cardiologist did a stress test and holter monitor and said no problems but I feel really lousy when my heart rate drops so low. If I exercise the rate goes up but then drops quickly back to 30-40 bpm. My family doctor prescribed amlodipine to increase my heart rate with limited results. Blood pressure is usually around 120-130/80. I have regular PVC’s on an ekg. Occasional light headedness during times of low heart rate. Any suggestions on how to solve my Bradycardia permanently? I enjoyed reading your article. Thank You for your input.
Bradycardia in itself isn’t usually an issue unless symptomatic. The only permanent cure is a pacemaker.
you can follow my twitter at @MustafaAhmedMD
Hi. I’m 39 male and recently the ER diagnosed me with bradicardia and said to speak with a gp.
I’m not fit (haven’t really done anything athletic since I stopped playing football when I was 20), I’m overweight (175cm/110kg) and I do minimal activity as a result of long work hours (at desk in office) and travel time of work commute (over an hour each way), but my rhr is 51-54 and when I am relaxed on the couch or in bed before sleeping it drops to 47-49. When I sleep it drops further to 38-45.
For over 3 years I’ve been suffering from chest tightness and pains, constant dizziness, shortness of breath and what I call “episodes”.
There are two types of episodes I have:
1. I have a sudden onset of fluttering feeling in my chest, get pins and needles down my left arm, and find it hard to breath as it feels like someone is sitting on my chest. My heartrate usually remains at my normal bpm.
2. I have an instant heartrate rise and my heartrate will sometimes oscillate up and down for 1-5 minutes. Eg. I will be relaxed on the couch watching a sitcom and have a heartrate of 55 and then as quick as one can click their fingers my heartrate jumps to 100-110. Sometimes when this happens my heartrate will then oscillate between 100 and 70. I also find it hard to breath, like I am trying to catch my breath, and I feel dizzy.
I understand 110 is not high, but when you consider I have a rhr of 51-55, I’m just relaxed watching TV and then that sudden jump in heartrate is double my normal heartrate, you may appreciate the unsettled and concerned feelings that result.
I’ve been to the ER numerous times, but each time they do double blood work and EKG and there is no evidence of heartattack.
I am working with my gp to try and find the cause of the problems but no answer has been found so far.
I’ve done the heart ultrasound, a holter, numerous bloodtests, numerous ekgs, but nothing has been found.
I also get my BP tested every two weeks and get told it my BP is “perfect” but “heartrate is a little low” .
My gp is quite relaxed and doesn’t seem all concerned about it all, but it’s been 3 years. Should I be concerned and pushing for more tests from the symptoms I’ve described?
Any suggestions on what else to do so I can move on to trying to fix the problem?
I just want to sort it out. It’s been impacting on my life and family for 3 years and to be honest it is a struggle.
The good news is that most of your testing seems to be reassuring. It seems you are still concerned and also you would like an answer to the symptoms. Ask yur gp if they will make you a referral to a cardiologist to discuss and if anything provide reassurance.
you can follow my twitter at @MustafaAhmedMD
Hello
I had a test ealier at school, and my heart rate was 54-57. My teacher said its really good but im a bit concernded cause lately ive been feeling lightheaded. I ran 4 times a week for an hour and play sports for about 1-2 hours 3 days each week. Im not sure if its my physical activity that makes my heart rate low or because i have runny nose and the lightheaded sometimes. Ive been feeling a little dizzy for a week now, so i havent done any physical activity cause i feel tired and scared id pass out while running. Im planning to see my family doctor soon though. Just little suggestion would be nice
Does the heart rate dip specifically at the type of symptoms? That should be the case if they are related.
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Hello, I am 28 female, 222 lbs, a couple years ago I had an episode where my chest was racing, felt like I couldn’t breath. Went to ER and they said panic/anxiety attack and sent me home. A few months later I found out I was anemic which they said could have been responsible for the SOB, palps so they prescribed Iron. Now I have been wearing a FitBit for quite a while and my heart rate fluctuates from 40s to 90s all throughout the day. I have a sit down job and while I’m sitting not moving it goes from 50 to 80 to 70 constantly. I have had EKG and 1 ECG and were told it was all normal. BP has always been normal. I still have times with chest heaviness, when I try to fall asleep feeling like I can’t catch my breath. Any insight would be appreciated, thank you
Do the episodes you have correlate with the lower heart rates?
90% of the time yes, I start to physically feel the symptoms which cause me to check my heart rate on the fitbit which shows the low reading, but again sometimes I feel the symptoms, check and it’s 60 or over.
Hi my name is Maria I am a 17 and I think I might have Bradycardia. At first I was lost and I went to see a neurologist and she thought it could be seizures from my previous history as a baby. But the medicine I was advised to take did not help at all. I always get a feeling every day where I loose control in the whole left side of my body and I feel like fainting I also always feel confused and tired and get a pain in my chest that makes it hard for me to breath I checked my bpm and it goes down to 40 every time it happens maybe I’m wrong and I don’t have Bradycardia but I just want too know whats wrong with me the doctors that I have seen don’t have any answers for me or my family and I just want to know if I’m okay.
The first thing to do is to characterize the heart rate and relate it to the symptoms. Maybe a monitor can help to do that, if the symptoms happen frequently then a monitor for a few days could see the nature of the heart rhythm during the symptoms and help determine any relation. A heart rate of 40 is not particularly low and is likely to represent a vagal type reaction however better to gain more information first.
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I’m 27 with BAV, 3.6 aortic root, high blood pressure(under control) and occasional arrhythmias. My cardio said i’m stable and not likely to need surgery until 50’s 60s. This year i got echo, stress test, ct scan, ekg, blood test and 24hr monitor. None of these tests caught the arrhythmias, but she said it is NOT afib. Suggested it is probably a sinus arrhythmia. I’ll describe the episodes below:
+ They happen in-frequently…sometimes multiple in a week, sometimes i go a couple weeks without any. I’ve gone months now without one during the day.
+ They last 5-30 seconds mostly, 1-5 mins sometimes, but in the past have had episidodes that lasted 20 to 45 mins.
+ They occur mostly at night in bed, laying down, but also from sudden/awkward change of posture, or drinking coffee/alcohol, from stress/anxiety.
I took a beta blocker for blood pressure but it knocked me into the 40s sometimes and gave me ectopic beats. Now I’m constantly checking my heart rate. Off the beta blocker now, my heart rate is usually in 50s/60s…but sometimes when anxious or during the day it gets up to the 80s/90s…is that normal? My cardio said I have a very abnormal, though sinus heart beat. Beta’s really do great with my bp(below 120s) but the dropping of heart rate to the 40s makes them not worth that, correct?
Do you think it’s likely i’ll need a pacemaker? Sure hop not
I am. 53 year old male, 185 lbs. Yesterday morning I went to my GP for a physical and shortness of breath and fatigue. I also.get short dizzy spells about once per month. She checked my heart rate which was 36. I have always had a lower heart rate 45-48. She sent me to ER to see cardiologist. They did stress test, ekg, and echocardiogram. He said all was normal. Thyroid level was also normal. I was observed overnight in the hospital. Heart rate went down to 34 during the night. I’m being released today. Cardiologist said to check with a lung specialist and have a sleep study due to snoring. I’m still concerned. Should I have a second opinion?
I’m 41 yrs old when I was 21 I had hysterectomy after birth of my child when I woke my heart rate was in 20 and 40. I was placed on cardiac unit. After lung, blood, meds, checked nothing. They put me on slobid to try increase rate. It was fail and pacemaker I wouldn’t allow at the time. At 27 I go to hospital thinking I was having heart attack Dr says it’s fluid between breast bones and continue on lasix 80 mg as I have since age 21 in 2010 my face start felling funny I call my dentist thinking tmj he refers me to er the university med er stated I waited to long but it was tia I was released I go for follow up and a cardiologist says it wasn’t tia I was fine so I seriously give up on Dr so after 20 years of being tired swelling nasusea muscle issues allergies to steroids any type dry eyes dry mouth all I drink is water period. All test blood wise is normal And several other things I can’t function in life I tried another Dr now I’m on 21 day monitor I got nucular and some other test the cardiologists say they think its metabolic and my heart slowed because of some l word and send me to a internal med Dr now saying I may be one that has weird case that hardly diagnosed. I’m just tired I been to every kind of medical Dr and they treat each symptom. Isn’t there a whole symptom? I’m just need help. I want to function in life I’m young. If any help u can figure I’ll drive etc please let me know. When I sleep I wake up swollen Dr say my heart rate drops so low I secrete fluid from veins if I fly I swell. My muscles in neck back shoulders stay in knots not even Dr can get them out if I move I pull them. Can you help me or know who can please [email protected]
Oh and don’t forget the weight gain of instant 45lbs I’ve never been this big ever. I don’t eat if I eat a bite I’m full so it makes no sense I should be anorexic truly.
Has the thyroid been checked?
I felt some guidiness and checked blood pressure. It was 140.about normal. I am not diabetic. When I checked my ecg my HR was 48.my eco test report is normal too. What could be the reason.
Recently I have been having random bouts of low heart rate, usually in the 40s. It causes lightheadedness, shakiness, stomach upset, and general unwell feeling. My doctor initially thought low blood sugar, but it is pretty stable after testing. And they have not done anything else. Should I be worried about this? I’m 32, not remotely an athlete (I’m partially disabled), and have no thyroid issues (checked every year). My normal heartrate is in the 80s-90s range resting around 70ish.
I have issues with a low heart rate that are concerning to me. I have EBV, chronic fatigue syndrome and fibromyalgia. I stay fatigued on a daily basis, am severely limited by the fatigue and rarely leave home. I also have hypertension and antibodies to CMV and Herpes 2 simplex. I have been on the beta blocker Carvedilol for some time. This is not my first beta blocker. I usually end up running into trouble with them as they will lower my heart rate too low. However I do not know if that is the case currently or if there is something else. I have also had some periodic episodes of hypotension with readings as low as 80/50 something and this usually happens in the overnight hours or after a period when I have really overexerted myself, etc. I have brought this up to my doctor countless times and he just ignores me. But when I get up this morning and have a BP of 134/77 and a heart rate of 46 yeah I am concerned. That in my opinion is too low under any circumstances. When I am extremely fatigued and exert, especially like going up and down stairs or in the extreme outdoor heat/weather my heart rate and BP will rise; my BP usually rises when I have an acute stress/anxiety attack or if I am nervous/anxious. My doctor has me on the Carvedilol 2x a day 6.25mg + Lisonopril but I stopped the Lisinopril and went down to one Carvedilol when I started having low BP issues 6-7 months ago. I have also been in a pretty rough patch with the EBV during this time. I do not get dizziness with any of this, nor chest/heart pain, and I never faint, etc. I do have Raynaud’s like symptoms and get some hand numbness at night but In often lay with my hands under me so that may be causing that. I am just concerned about these low heart rates. I can barely function in basic activities at home like housework without being exhausted. I go to bed that way, wake up that way. I am in the bed 90% of the time. Today thus far I have not gotten my heart rate above 62, but no other symptoms other than a low grade temperature from this EBV flare. I have been worried about possible myocarditis; I have had EKGs-nothing showed. I have had lab work to check CK levels for heart muscle damage and lab work for tronopin-normal. I just don’t know what to think. I do have slightly elevated LDL cholesterol which my doctor said to lower through diet since I cannot tolerate statins. I am starting to worry I may need a pacemaker. Any words?
With the raynauds like symptoms and the low heart rate its probably wise to consider stopping the beta blocker and using a calcium channel blocker like amlodipine to control the bp, discuss with your prescribing physician.
you can follow my twitter at @MustafaAhmedMD
I also have temperature variations ranging from 97.7 to 99.6. The 99s are usually when in a EBV flare. I do have a diagnosed Vitamin D deficiency which is being corrected with a once a week 50,000 unit capsule for slightly over a year. I did have a T4 test or T3 that was right at the bottom of the reference range, but not abnormal. No adrenal disorders. Possible dysautonomia?
When I wake up my hr is usually low 50’s. One morning after little sleep my hr was 48. I felt light headed for couple of hours after. It has not happens since. I am 60 pounds obese.
I have been experiencing bradycardia for many years, with an avg heart rate of 50, but since Oct I’ve experienced frequent syncope episodes with severe Cluster Migraine pains, allergies to foods, and OT/PT exercise movements and my blood pressure climbs in the mid 200-300 range and my heart rate drops to the lowest of 37! After the syncope episode, I am left with weakness, extreme fatigue & exhaustion. What could be the cause?
Hi I fainted two days ago and since had a low heart rate feeling v dizzy and tired ,, my normal Bpm is between 55-62 I v fit persin age 43 female , but it dropping to 46 and i feel v floaty with it ? I went to A and E nothing seems obviouslty wrong … should I get further test do you think
Hello Dr. I recently went to the emergency room because I felt my heart sink. like a sudden slow down of heart rate. I felt scared and then my heart rate raced then felt like I could get enough oxygen. I checked out fine in ER, EKG, Chest X-ray, ultrasound of heart by dr and labs came back normal. I occasionally get a similar feeling once in a while not as bad. My heart rate varies as low 40s to 140. When stressed. Sometimes feel it in my throat, bend down exert energy and worry having a blank thought cause heart to sink or drop feeling. I have the Apple Watch and sometimes I think I see my heart rate super low and thought I saw 3bpm for split second. Am I ok, I had panic attacks in the past and had major manic euphoric episodes twice. But this is the scariest, should I be concerned or is it anxiety?
Your advice is greatly appreciated.
I’m thinking of buying a device to use on iPhone to check your own ekg.
Next best step here is an outpatient evaluation by a primary care physician then a referral to a cardiologist if necessary. Im not impressed by the self monitoring ekg devices, i find they create anxiety and misdiagnosis in most cases as things stand.
you can follow my twitter at @MustafaAhmedMD
This was the interpretation of the result of my boyfriend’s treadmill stress test. What does it mean?
Resting ECG: Abnormal
Sinus bradycardia (40 bpm). First degree AV Block.
Exercise HR: Abnormal
Inadequate HR response
Interpretation: Inadequate treadmill stress ECG at 18.1 METS, 82% MPHR
Remarks: Patient achieved 82% maximum heart rate
I am a 65 year old male and have a resting pulse rate of 43 BPM. I am not an athlete but I do walk 4 miles daily in about 64 minutes. I also take 0.1mg of clonidine at night, just once a day,
and Lisinopril/HCTZ 20/12.5 twice daily.
Should i be concerned or does the medication cause the low heart rate?
In the absence of symptoms a heart rate of 43 is not necessarily an issue, the clonidine may be contributing some, i would recommend a baseline ekg.
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I am an entirely asymptomatic male in my late 60’s, still working as a professional. I am physically active, briskly walking 2 miles each weekday, working out each weekdays, plus playing a contact sport each day of the weekend. My normal heart rate has been in the 40’s for some time, and has slowly declined over time; I also take a blood thinner for Afib and a statin for moderately elevated cholesterol.
Recently I had an emergency room visit (for a neurological issue, apparently unrelated to heart issues). While I was lying on the gurney hooked up to IV and EKG, my heart rate was measured in the 30’s — LOW! — and now I am being advised to have a pacemaker implanted. But since returning from the ER my heart rate has been back in the 40’s (and in the 60’s after workouts). I am wondering whether my low heart rate could have been an artifact of lying around on the gurney for a day
I gather that pacemakers are contra-indicated for those playing contact sport (which is good for my heart as well as for my psyche) so my concern is that the suggested course is actually BAD for my heart in a way. There is a new pacemaker without leads (maybe better for contact sports) but it has been in actual use for such short time that my concern is that we have not had enough experience to assess whether there are long-term problems
Thoughts?
Have you seen a busy specialty dedicated electrophysiologist. Its important to have that opinion prior to proceeding with a pacemaker that may well not be needed.
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Hi Doctor,
I only recently started focusing on my heart rates. In a week, I do an hour of swimming, couple of hours of sports and an hour of yoga.
My hear rates are around 54-58 while resting. is that normal?
Regards
That can be normal, yes.
you can follow our twitter at @MustafaAhmedMD
My age is 45 men .my heart rate 60 this normal .i am eat prolomet xl 50 tablet daily morning once.
I have high blood pressure… Dangerously high sometimes. Doctor put me on a beta blocker. Now my heart rate stays at around 50bpm but my blood pressure is still high. Any ideas??
Beta blockers are not typically the best agents for blood pressure control.
Im 27 and 230lbs (way overweight for my height). My pulse has been in the low 50’s while resting and sometimes in the 40’s. I recently have been taking losartan hctz for blood pressure. I have been fairly active with my new job of 2 months. I occasionally have shortness of breath when resting on couch. Any ideas?
I have always had a low heart rate around 50 but seems to me since taking bp medication, the heart rate has dropped to low 40’s. Can you comment on the relationship of bp meds to bradycardia and as to whether one method of treatment for high bp is preferred over another?
BP meds such as calcium channel or beta blockers can drop heart rate.
I’m a 43 year old female. Reasonably fit. My resting rate is usually in the 40’s – low 50’s. Recently it had dropped as low as 37. I am often tired, have frequent headaches, feel cold. Is this something I should get checked out?
It may be worth having an EKG performed and thyroid testing as part of an initial work up.
you can follow our twitter at @MustafaAhmedMD
Hi doc. I’ve been recently diagnosed with bradycardia and have started having new symptoms. I started having a numbness in my left upper arm and I’m unsure if I should go back to the hospital. I have an appt set up to have a holter monitor put on near the end of June and feel that that might be too long a wait. Should I go to the hospital?
I’m 26, I’ve had test done like 48 hour holter monitor, and the heart ultra sound thing forgot what it was called. Doc said my heart’s perfectly healthy, my resting heart rate gets down as low as 38 when resting, when sitting down through out the day it can be in the 40’s. Is this okay? I have bad anxiety and now I get to paranoid to skateboard cause I get anxiety when my heart starts beating hard.
This was the interpretation of the result of my boyfriend’s treadmill stress test. What does it mean? Thank you for your response 🙂
Resting ECG: Abnormal
Sinus bradycardia (40 bpm). First degree AV Block.
Exercise HR: Abnormal
Inadequate HR response
Interpretation: Inadequate treadmill stress ECG at 18.1 METS, 82% MPHR
Remarks: Patient achieved 82% maximum heart rate
18.1 mets is very reassuring. I would discuss with the physician responsible for the test the reason for it being labelled as an inadequate test?
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Hello Sir, My Heart rate was low in the year 2016-2017 i.e 64 then in 2018 it was the same but recently it went to 44 ,actually I run daily for 15Km and I have no problems till date, But doctors say that my ECG is abnormal and they have referred TMT test, Kindly throw some light
I have a regular low resting heart beat in the 30’s. The last couple times at the doctors or hospital they pointed it out to me. I do wake up with weird things happening with my tongue going numb and numbness racing up and down my right side of my body and can’t talk. By the time I make it to the doctors office, they are gone and I am back to normal. They take test with heart and everything thing come back as normal. They always tell me to get my low resting heart beat checked out because it could be dangerous and my be causing this to happen but they do not know for sure. Your thoughts?
I would start by wearing a monitor to characterize the rate and see its association with the symptoms.
you can follow our twitter at @MustafaAhmedMD
I have RHR 40’s drops to 30’s at night. I am 69 and have been running for past 4 years. I have recently had heart palpitations and dizzy on occasion. And lately I am getting progressively tired and unable to run like I could this time last year. I have never been a nap person but a 5k had me sleeping most of afternoon. I had labs and all those numbers were great I’m unhappy feeling old all of a sudden
Need evaluation, an ekg, maybe bloodwork possibly an exercise stress test and a monitor as the next step.
you can follow our twitter at @MustafaAhmedMD
I was diagnosed last August with Orthostatic Hypotension and possibly POTS, it came on very suddenly and without warning. My heart suddenly had a resting of anywhere from 115-120 then when standing or active sometimes as high as 200. Approx. 5 months after having this happen I found out I was pregnant. I had to be followed during my pregnancy very closely and just gave birth 7 weeks ago. Approx. two weeks ago I started feeling extreme fatigue and a feeling of “breathlessness” at times. At that time I began watching my rates closely and have found I’m extremely low. I’m dipping down into the 40’s and 50’s while awake and asleep. Should I be concerned about the sudden change? It appears I’ve went from once extreme to another.
With the fatigue and breathlessness i would recommend evaluation by a cardiologist.
you can follow our twitter at @MustafaAhmedMD
I have been taking BP pills for about 4 years. Recently I noticed my bp is always around 108/65. Also, after I started wearing an Iwatch, I noticed my resting heart rate is around 48. Two times at 32 in three months. I am 55, BMI 25.6. Should I stop the high blood pressure pills and be concerned about the low resting heart rate? Thank you.
I would discuss the issue with the prescribing physician.
you can follow our twitter at @MustafaAhmedMD
Hello,
My I’m a 30 year old female in good health and am experiencing episodes daily where my heart rate drops to 31/32bpm. These episodes last for a few minutes and leave me feeling faint and tingly. I had a 24hr holster monitor last year which showed I had a low resting heart rate and several hundred missed beats. An ultrasound showed I had a mitral valve prolapse and an exercise stress test showed that my heart rate elevates when exercising. I was told to see a cardiologist every 5 years to have this monitored. Should I be concerned then my heart rate drops this low and is symptomatic? Would you recommend seeing the cardiologist again? Thank you for your help.
If associated with symptoms then i would recommend an evaluation by a cardiologist, its important to see these episodes on a monitor and correlate with symptoms, reviewing medications and history, and such, prior to making treatment decisions.
you can follow our twitter at @MustafaAhmedMD
Hi ,
I’m a 30 year old female and I’ve recently had a 24hour ecg monitor fitted as I’ve been having episodes of dizziness and palpitations on the result it showed I have episodes of ectopic beats but my heart always returned to normal rhythm, my average resting is 63bpm and dropped to 39bpm whilst asleep should I be worried of this ? It’s has made me extremely anxious as I had it done 2 years ago and it was 41 at the lowest..
Low rates during sleep are not necessarily bad, the results shoudl be interpreted and discussed by the referring physician.
I am a 36 year old male who is not over weight and stay active. I have had a rapid decrease in my breathing in the last six months. I went to my primary care doctor and they did an EKG, which came back abnormal so I was ordered to where a halter monitor. The results said 10 pacs 1 arterial run and bradycardia and sinus tachycardia. I did a heart echo and it said mitral regurgitation (mild) right valve dilated and low normal ejaction fraction of 50% . Lowest heart rate recorded was 46 highest 175 . Is this common at my age?
the interpretation is often subjective,i would recommend you discuss these findings with a cardiologist who can review the study.
you can follow our twitter at @MustafaAhmedMD
I’m 41 not in great shape, a little over weight my resting heart rate is 58 is this bad? I did a day with a heart machine EKG thing everything normal 4 years ago, should I be worried?
58 is perfectly normal if thats what it normally is.
you can follow our twitter at @mustafaahmedmd
I have POTS and alternate bradycardia and tachycardia. I keep thinking they missed something with my heart but a year ago I had holter monitor for a month, echo, and ekgs. Is there any other tests they might want to run or should I chalk this all up to POTS . I’m miserable some days I wish I could find a cardiologist who was knowledgeable in this area..
I am 50 years old man and my resting heart rate is 48. I do excise everyday and run up to 5 miles on weekends. Should I be worried?
Not if you are able to be active and there are no symptoms. A baseline EKG wont hurt.
you can follow our twitter at @mustafaahmedmd
why do my heart beats fast in the mornings I am a 55 year old female, and i have high blood pressure. i would go to bed with a blood pressure of say 25/85 after taking my medication, and would wake in the mornings with a racing heartbeat and a blood pressure reading of 150/95 and a pulse between 60- 67. the is a regular basic. I am concern.
On July 12, 18 I had ‘what was for me’ a MAJOR heart issue. I’ve had occasional arrhythmia throughout my life, more so as a young girl. But NOTHING like last wk. My heart went into INTENSE rapid & arythmic POUNDING & THUMPING that lasted almost two hours. I could barely breathe & was very light headed. I had my arms wrapped tightly around my chest as if to hold my heart in place. As the intense pounding began to slowly subside, my left arm went numb & I got a horrible stomach ache, the palms of my hands & souls of my feet were wet & cold. Into the latter of the 4th hour the arythmia gradually returned to a more natural beat, although very faint.
I’ve increased my B12, vit C, D3 & Magnesium to 3 X’ a day. I’m not on any meds. It’s day 8 since that “event” & I’m still weak & feeling exhausted. I keep trying to avoid the ER but I feel my heat is in trouble. I don’t have any physicians but have excellent insurance. Any insight?
I would at least get a basic cardiac evaluation.
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When is a slow heart rate to slow. My normal heart rate is always below 60 and has been as low as 38. I have woke in the middle of the night with rapids heart rate before as well. Last fall while out hunting I passed out an on rare occasions I get light headed.
Hi i am 38 year old female not to active and a little over weight I have been having a lot of dizziness lately as I suffer from anxiety I feel I’m being ignored by my doctor I have noticed my resting heart rate is sitting between 55 and 58 most of the time this is unusual as my hr was always around 65 previously should I be concerned
I’m 42, male and I’ve had PVCs off and on since my early 20s. Sometimes it’s just a thump and others feels like fluttering. I’m 6’ and 214 lbs but my weight has fluctuated between 200 and 250 since my early 20s. I never exercised regularly until about 3 years ago when I started walking daily then later jogging. I’ve also eaten more healthy for the past 10 years. I do drink in moderate amounts, usually no more than 2 a day 4-5 days a week but sometimes I’ll overdo it. I had a really high resting heart rate (80s-90s) about 3 months ago and I was also have GERD issues. My blood pressure was 140s/90s too but normally is 130s/80s. The PA I saw put me on atenolol as he said it would lower my heart rate, bp, and maybe help with the anxiety I was feeling. It would also stop any palpitations which I hadn’t really had for a while. Two months on the drug was absolute hell! I was so fatigued and my heart rate was so slow (mid 40s at night). I stuck with it because I was trying to get through a stressful time in my life and I started exercising daily again (brisk walking up hills) and eating more of a plant based diet. I lost 25 lbs. I then asked to be weaned off the atenolol and my doc had me take 3.125 mg x2 daily of carvedilol. This wasn’t as bad but I still wanted off. After two weeks he told me it was ok to stop and gave me a calcium channel blocker but after going off carvedilol my bp never went above 130/80 so he said to not take it. I recently had a heart scan and my calcium score was 4.13 and he told me I could stop simvastatin which I’d been in for 8-10 years. My blood chemistry has been good for at least 5-6 years with my hdl being too low (<35 mostly) is the only negative and my blood sugar hovers around 100 but my a1c is always below 5.5. A week after getting off all drugs my heart rate rose a bit during the day but at night when I sleep it can be in the mid to upper 40s. I still feel extremely tired in the evenings but on nights when I have wine for dinner my heart rate doesn’t go below 50 while sleeping. I’m sleeping better now that I’m off the beta blockers (8hrs vs 5-6 before). My bp ranges from 105/68-130/80 now and during the day my heart rate is in the 60s mostly. My heart rate is high when I do any exercise and walking up 4 flights of stairs to get to work it’s at 145 bpm. I’m not an athlete by any means so it scares me that my heart rate is still low after getting off the meds. I have monitored my heart rate with a Fitbit and Apple Watch for 2 years and it never went below 50 while sleeping even when I was running daily (but I was drinking more then). All recent blood tests including thyroid, and liver are normal. EKG two months ago showed normal too. My main question is could this fatigue and low heart rate at night still be a residual effect of the beta blocker? Or could this just be my normal sleeping heart rate now when I don’t drink? I’m seeing my cardio doc next month so I’m going to ask him about it all too and my pcp I see again in two months for my physical. I just want to know if there is something else I should be asking them about or testing for.
The beta blocker wouldn’t remain in the system this long and this is likely your rate. Its good your heart responds appropriately to exercise. A heart rate of 50 in general is not worrying. A work up by a general physician for causes of fatigue my be useful.
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I’ve always had a low heart rate. I was pretty active as a younger man. Surfing and racing Hawaiian canoes in the ocean. I’m 41 now though and don’t do much cardio. My sleep number app tracks my heart rate and my avg was 42 last night. What should I look out for as a result of this low heart beat?
If there are no symptoms then nothing other than your usual dr follow ups.
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I m 75 years old and extremely active. I’ve had hypertrophic cardiomyopathy for over 30 years without any symptoms. But with no apparent cause, my heart rate (always normal before) has suddenly dropped to 36-43 in the past three weeks. I feel fine and have continued to exercise without any problems. A brisk three-mile walk gets me to the high 50s or low 60s before returning to the low numbers. I will see my cardiologist next week, but what could possibly have caused such a change? And without symptoms, does it make sense to take any action? Thank you.
Are you taking any medications for the HOCM? A 12 lead EKG would be a good place to start to characterize the heart rhythm.
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Dr. Ahmed,
My cardiologist prescribed a blood thinner (xarelto) to reduce the chances of a stroke. In the absence of symptoms, she has decided that no further action is needed for now. I will have an echocardiogram on October 11.
No, I have never taken any medication for the HOCM since it never presented any symptoms. Because of the HOCM, my EKGs have always been irregular.
Meanwhile, I continue to be active on a daily basis without any problems.
Thank you,
Joseph Sanchez
Hi Dr,
I’m a 52 year old female. I had surgery 2 weeks ago. I had a septoplasty, nasal valve implant, turbinate reduction, uppp, tonsillectomy. When I woke up in the recovery room and asked for pain medicine they wouldn’t give me any, they said my heart rate was only 42. So for nine hours I went with no pain meds because my heart rate took that long just to reach 60.
I had an EKG two weeks prior and it was normal and chest x-ray which was normal. I don’t know what caused my heart rate to drop so low. My heart rate was low when I left the next day it was only in the 50s. I have been lightheaded, weak, since then.
My normal heart rate was always in the high 70s, even going as high as 90 just walking across the room. I’ve been using a fit bit since I’ve been recovering at home for the last two weeks and my heart rate at rest, not sleep, has been in the 50s almost every day. It only goes up to the 70s and 80s walking across the room. As soon as I sit down, within two or three minutes it drops back down to the 50s, even the high 40s. This is not normal for me.
I am 5 foot seven and I weigh 175. As I said I’ve never had any issues with my heart rate being low until I was in the recovery room, and my resting heart rate has not been back to normal since then. Which is in the high 70s.
When I went to see my surgeon for a follow up after two weeks, even walking across the parking garage to his office, my resting heart rate only reach 60. She told me I should go see my GP.
I am just had my thyroid levels checked the previous month, it was 1.3 TSH. I do take levothyroxin. My testosterone was also high the month before. I do have a 2 cm nodule on my left thyroid which was just discovered a few months ago. I did have a biopsy and is normal for now . All the causes of bradycardia don’t fit me at all. So something happened during or after surgery that cause this, and now it’s not returning back to normal .
Do you have any idea what could’ve caused this? I’m not taking any medicine for the high testosterone. The only other medication I take besides my thyroid medicine, is Dexilant for my acid reflux.
Thanks Sherry
The immediate response post surgery was likely due to pain and associated circumstances and is known as a vagal response and can be common. As for the findings now they are likely not explained by surgery. The rate itself can be normal for many people, and its difficult to know if its related to the symptoms at all. A 12 lead EKG would be the initial step with a history and physical. Then consideration of a monitor with a symptoms diary to see if there is any correlation.
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I have an active bpm of 42 on average not sure what resting is. Have no symptoms to really worry about. I am very active during day work 10hr day average and am pretty tuckered out at end of day. Blame this mostly from not sleeping well. Should I have concerns.
I’m 48 years old, I keep looking at my fit bit and my heart rate is low 50’s or high 40’s….. I’m starting to panic that something is wrong. Is this s signnif a heart attack?
I’m 48 years old, I keep looking at my fit bit and my heart rate is low 50’s or high 40’s….. I’m starting to panic that something is wrong. Is this s signnif a heart attack?
The heart rate itself in the absence of symptoms isn’t a cause for concern, if concerned go get a baseline check up and an EKG.
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Hi Dr. Ahmed,
I’m 34 male, 167lbs and play soccer 3 times a week. My PC ran an EKG and it came back with 39 resting heart rate. He is worried that it might be bradycardia but I feel fine. I went in to have him look at my throat being tender when I swallow.
Since my initial appointment on the 6th, I’ve worn a Holter monitor for 48h and had a cardiac echo in the last 3 days. I won’t see an cardiologist for another week (on the 18th of Sept.). I am wrecked with worry!!! I do have a baby on the way and have been stressed lately but according to my FitBit Surge my resting heart rate is between 48-52 depending on the day. I wear the FitBit during the night as well and my heart rate drops down to 38 at night.
FitBit historical data shows similar data over last 2 years. Should I mention that data to the cardiologist?
A resting bradycardia in a physically active individual may be entirely normal as is decrease in heart rate during sleep. If your echo and holter are without other issue they will likely reassure you as to the benign nature of these findings.
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I don’t think I should be concerned but I’d still like to ask. I will be 40 in a few weeks and have always had low heart rate. I wear a Polar HR monitor/activity tracker on a daily basis. I have a very sedentary job, however I teach group fitness classes 4 days/week and often do other exercises as well. I have a great HR recovery when working out, but it still concerns me that my HR during the day can be as low as 38 and probably averages around 45. My father had to have bypass surgery around my age (not sure of the exact cause) and then 3 more vessels done about 10 years later. I’m not in regular contact with him at all, but now he’s in his 70s and is very active and seems fine. I don’t feel like I have any symptoms but I do get anxiety at times which of course makes me very aware of my heart at that time. Would these numbers cause concern to you? Articles always say that “young healthy athletes can have HRs as low as 40”, but then I read other things that say “the lowest HR on this study was 36” (and I look and see that I’ve been down to 32 before). Help?
Likely not of concern but would recommend a 12 lead EKG as a starting point.
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I was in the hospital for pancrititis 4 weeks ago my heart rate usulay was in the 70s ,but after having left the hospital 3 weeks ago and going in a strict no fat diet and liquids and 3 days of no food and a week of only a gallon of water a day . I have lost 20 lbs I weighed 290 now 274 in 3 weeks . But IAM scared and concerned my heart rate drops and stays in low 50s and when laying down in 40s and when falling asleep I check and it’s in 30s . Emergency room monotered me for 6 hours oxigen levels fine but heart rate fluctuated in low 50s and 40s . They sent me home Sayed I was fine to make an appointment with cardiologist . Can having drank too much water and no feed caused this .
I am 48 years old and have had 3 syncope episodes in the past 3 weeks. First my right arm and right leg start to tingle and then become extremely weak. My extremities (arms, legs, and stomach) become quite cold and my right hand becomes numb. Then I pass out. Upon awakening, I start to have tremors that affect my entire right side (face, neck, arm, hand, and leg). I have been taken to the ER 3 times in less than a month. The only thing they’ve found so far is low phosphorus and a lowered pulse rate (54 and in the 40’s when sleeping) with lowered blood pressure. My BP has always been on the lower side. I used to run marathons, but that was over 4 years ago. Some have suggested electrolyte imbalance, some TIA’s. I have an appointment with the cardiologist on the 16th….what can I expect?
I had a low resting heart rate of 49 just before back surgery. Had it noted to me again when being checked in for dr visit. Wore a holster monitor for 48 hours, dr said I had a low heat rate at 39 and looks like my heart did some extra beats. Scheduled to see cardio dr Oct 25. Am fatigued and concerned if I should rest when fatigue hits or push through it. No other symptoms although I did have a terrible chest pain that lasted a few minutes a few months ago. Have had a stress test and EMG after that and okay.
A heart rate of 40, although can possibly be linked to fatigue if it doesn’t rise with activity, is not likely to be overtly dangerous.
you can follow our twitter at @MustafaAhmedMD
I had a pacemaker implanted a few weeks ago with 2 leads, one in each of the lower ventricles, The purpose was to avoid the recurrence of a 7 second heart pause I encountered and to treat a left branch bundle block that I have had for the last 30 or more years with no symptoms. The 7 second pause was detected, and I did pass out momentarily, by a loop monitor I had implanted 2 years ago to monitor my a fib as well as my low heart rate that I also have had for more than 30 years. My fit bit registered a rate as 29 on many occasions at night. I have had no symptoms other than the pause and many TIAs experienced throughout the years resulting in a PFO closure I had done about 8 years ago because a TIA lasted more than the usual 60 second or less. The PFO closure possibly created the A Fib.
My concern is that the pacemaker has limited the lower heart beat to 47 (according to my fit bit) and I have been waking up at night not getting the continuous nights sleep I was used to. I tribute this to the 46 which used to approach 30 with no symptoms. My doctor is reluctant to lower the rate but my sleep is affected. Am I correct in my layman’s diagnosis.
Not sure, the only way to know would be to temporarily lower the rate to 30 for a night and see if you improved.
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Hello,
I am a 37 year old male, I have been over weight most of my life, about four months ago I started diet and exercise, I have lost 70 lbs. I now weigh 279. Former smoker, I have quit for about 7 years, I smoked about 2 packs a day for 15 years. I do use cannabis from time to time. I am a type 2 diabetic with an A1C of 6.2, it is controlled with 2,000 mg metformin, diet and exercise.
I have had chest pain that radiates to my Jaw, left arm and back off and on since I was 16. I have had more cardiac tests than I can count. I will result the most rescent. Feb 2015 was my Cath that showed nothing greater than 20% blocked, stress test and stress echo were considered normal, ejection fraction was 55% with the echo. I had a cardiac cta in Feb of this year nothing near 50% blocked is how the result read with a calcium score of 433. I have an intermittent lbbb that appears to be rate related. I was on nadalol 40 mg for just over 2 years, I have weaned off it in the past month due to my heart rate going in to the upper 30’s at night. I have been fully off for 2 weeks now and my heart rate still drops to the upper 40’s when sitting or laying down. This scares me as prior to being on it my resting heart rate was in the 80’s. I have been doing cardio exercise 5-6 days a week since July 6th, I am now jogging 5-7 miles per day I do this in about an hour to an hour and 20 mins. I have not been able to work in the past 5 months due to worry about the chest pain that is almost constant off and on. It can come on at rest or during activity. I have seen 3 cardiologist in the past year and they all seem to think I am fine, but it just does not feel like it. I am dizzy all the time, it feels hard to breathe off and on and the pain numbness on my left arm can be intense. I have been to the er more times than I can count, 18 times this year alone and troponin is always negative and my EKG only ever shows my normal small oddities that they say are normal. I am at my wit’s end and cannot live like this. I have recently been sent for a MRI of head neck and mid back, I have issues at t5 t3 t4 t6 t9 t10 and c2 c3 c4 with some narrowing and chiari malformation with 5mm herniation. They gave me steroid shots at 2 of the t locations 6 days ago and the pain has not changed, just increased numbness in left arm. Any suggestions?
medical science donor for you.Ha! or a good assessment by a good diagnostics technician.
I have a RBBB, which I’ve had for at least 6 years. Does a RBBB get worse over time?
A couple of years ago, because of ongoing chest pain, I had a very thorough cardiology workup including 2 30-day monitors and numerous other tests (no cath though). There was never any cause found for the chest pain (or the RBBB).
I’ve noticed the last couple of months, my heart rate and blood pressure both seem to be going down. I have been very tired and sluggish-feeling. I also have newly-diagnosed sleep apnea that was dropping my oxygen to the low 70s (CPAP for 3 months now – no improvement in fatigue).
This morning, my BP was 98/59 (HR 51). I am not an athlete, in fact, very overweight. Wondering if this low BP and HR is okay and if not, could the RBBB have gotten worse?
RBBB is a conduction system disease, many people can live with this life long without issue, some people can have advancement of disease involving other aspects of the system that can cause symptoms. Would start with an EKG and potentially a monitor.
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I am a 50 year old male. I am fairly active and go to the gym 3-5 times a week. I usually do 20 minutes of cardio on an elliptical machine followed by 30-45 minutes of weights. I carry about 20 more pounds than I would like 5’9”, 200lbs. I was an athlete in high school and college. While I do a lot of sitting (computer and driving) with my job, I also do a lot of walking and standing.
I have had a low resting heart rate for several years now usually in the mid 40’s to low 50’s. It seams to slow down (45-50)and speed up (65-75)regularly throughout the day. I have an Apple Watch now and have noticed it dropping into the low 30’s a couple times while I am sleeping. When I’m on the elliptical machine it am am usually between 120 and 160 bpm.
I have no symptoms that I am aware of. No dizziness or fatigue. I do sweat a lot when I get warm. I also have occasional episodes of night sweats. Sometimes I will have them every night for a few weeks and sometimes I’ll go months without.
I was diagnosed with bradycardia at my last physical but, other than the sweating, I don’t have any symptomatic issues. I feel fine. I am not on any medications. Should I be concerned?
Not anything obviously concerning from your story.
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I’m a 44 year old female with a resting heart rate of 56 bpm according to an EKG done last week. I’m 97lbs. All blood work for lipids, electrolytes, and thyroid are normal. But my Dr. is concerned because I had some strange rapid flutters back between Aug. and Oct. I am by no means an athlete. In fact, running has always been a love hate relationship for me – I can do it, but I’d rather be active in other ways. It makes me feel like I’m going to explode, but I always thought if I spent the time to condition, it would be a piece of cake. In the meantime, I am constantly active. I never sit. This fall, I often raked 15 bags in a day. I can walk 4 days in a row morning to night around Disney with my eight year old with minimal downtime and zero problems. My father, who has heart disease (no surgery, but on meds for last 4 years), always had the same difficulties when it came to running, but he’s 74 and as active as ever. He just raked 37 bags in one day last week himself. I assume genetics can play a role and that a low heart rate might be normal for me?
Your heart rate is essentially in a normal range.
I’m a female 45, my resting HR at night falls between the low to mid 40’s, and then it in the low normal side during the day. But I have no adverse symptoms. I run a lot, marathons, triathlons, etc. I do martial arts, exercise regularly with weights, and my lab works are great. I feel very healthy, I eat well, (no meat, no alcohol, non-smoking), But some worry my HR gets too low when I sleep. My doctor checkups have never raised a heart concern, I’ve had a couple of ekg’s pre-surgery, I feel great. My blood pressure is around 70/110 a bit lower and higher, depends on time of day. Should I worry?
Night time heart rate in that range is generally not a cause for concern.
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In September I wrote the following: I’m 75 years old and extremely active. But with no apparent cause, my heart rate (always normal before) has suddenly dropped to 36-43 in the past three weeks. I feel fine and have continued to exercise without any problems.
New information: After an echocardiogram, a stress test and an EKG my heart rate remains the same (36-43) and only atrial flutters were detected. But now, I have developed the first symptom: dizziness and an upset stomach. They have happened twice in the last four days. My cardiologist thinks a pacemaker is in order, but I thought cardioversion was a good preliminary step before getting a pacemaker. I continue to be as active as ever–exercising twice a day without any distress whatsoever. Thank you for your opinion.
Have you seen an electrophysiologist?
I am trying to get an appointment in Gainesville and, as of now, I will see Dr. Massoomi at the UF clinic in The Villages on January 16. Do you know if he is an electrophysiologist or If I should try to see someone who is at UF?
Thank you,
Joseph Sanchez
I had the pacemaker implanted ten days ago. It seems to be working fine except for the fact that I have developed insomnia (not a single night of continuous sleep) as well as a low throbbing on the right side of my chest. Because of the holidays I cannot see my cardiologist until January 10.
Thank you.
I’ve recently been falling asleep at 8 or 9pm. I used to be a night owl. I started having chest pains. I went to the ER after 3 days of the pains. I’M 43, they ran all of the tests. Blood tests, echo, stress, etc. All normal except low bpm, when I was in the ER, my heart rate was around 45 to 50. It got down to 38 while I was sleeping and they rushed in to do an ekg. Docs tried to tell me I’m like an athlete, Lance Armstrong. My husband and I started laughing. Im a huge couch potato and smoker and drinker. I am 5’6″ and 140. Eveyone looks at me and assumes I work out. I explained to the doctors they are wrong. They told me my heart is healthy and sent me home. Ive been out of breath and weak and tired. I quit drinking and smoking at least. Ive started exercising but I’m still so tired. It’s really strange. I know my body, I know something is wrong, My dad has a pacemaker. I get so tired, I look at my husband and say, I have to sleep now, and put my head down and I’m asleep im seconds. It’s really scary. I think I need a second opinion.
Hi Doctor
I am a bit concerned about my low heart rate of 37 most nights while sleeping this can be 10 times a night where I am notified of this by my heart rate alarm on iwatch. My symptoms are a little light headed, shortness of breath. I walk around 10-15kms a day. Do you think I should be worried?
Hi I’m a 33 female with a 52 Rhr , I’m not athletic ( I don’t run or do much cardio) and I’ve had tons of ekgs, mris and Holter monitors I do get dizzy/ light headed especially when standing up. I’ve talked with my docs and cardiologist and they are stumped what should I do I feel like I’m about to pass out when I stand up especially in the morning
I am 81 years old female. I am hypothyroid (undertreated). I had a holter for 48 hours. The report says I had 3 rare Ves and 29 rare AEs. Are those ‘rare’ events considered ‘normal’? or are they a warning/dangerous?
This is relatively normal.
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Hey! Thank you for taking the time to answer all of these questions. I’m a 36 year old female weighing 120 and was recently diagnosed with Lyme disease. Before the diagnosis I was having panic attacks, chest discomfort, palpitations and pounding heartbeat. I have seen a cardiologist about 6 times where I’ve gotten EKGs (all normal) MRI or X-ray with contrast (normal), halter monitor, stress test (all normal). I got the diagnosis and have been getting treatment and most symptoms have gotten better. I still get the pounding heartbeat even when it’s 60’s-70’s. There are days when my resting heart rate is 80-90 and then days when I’m more tired and it’s 50’s-60’s and it’s beating softer. I freak out when it’s beating softer because I’m so used to it pounding. It will go up to 90’s-100 when I get up to do something light and then I sit down it goes right back down. I don’t exercise much because of the exhaustion from Lyme but I’m active throughout the day doing housework and other things. Is this normal?
Symptoms are normal, however the normal echo, stress test and holter monitors is extremely reassuring.
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My at rest heart rate has dropped from a consistent 73-74 down to a consistent 52-53. My BP diastolic number is now often less than 60 – common readings are 101/58, 94/52, 89/49. I have unstable angina like pains that can be severe at times. A headache all day most days. Always a tight full feeling chest. These symptoms have occurred after I had severe bradycardia that progressed to asystole (SCA, flatline) during a cervical spine fusion surgery. What advice can you give me for testing and what is possibly going on? I am very concerned that something has happened electrically that has caused my heart rate to slow over 20 bpm. Any insight you have to offer is appreciated! Thank you!
Hey. I am 36 female and was diagnosed with Lyme disease. I haven’t been able to exercise in about 6 months but will get out and about walking here and there so I’m not in great shape. I weigh about 115. My normal resting heart rate is in the 70’s and high 60’s. When I stand up sometimes and walk to restroom it goes to 100 and above but goes back down when I sit down. Last night I didn’t sleep well so have been very sluggish and tired and my heart rate sitting down is 57-58. Is this normal?
I should probably also tell you that I’ve had EKG’s, holter monitor, stress tests (all fine) recently had a echocardiogram and had mild dilation in right ventricle (I think is the terminology) but the doc said nothing to be worried about.
I am 72 years old. Recent physical exam showed all blood work to be. normal. LDL 97, HDL 85
triglycerides 65, crp .2 psa .4. Not on any medications. Supplements tajken are Vitamin D3 2000 mg., and 500 mgs of circumin daily. Pulse rate approximately 42 for at least the last 20 years.
Mediterrean diet with lots of omega 3s. Run approximately 2 miles every 3rd day and brisk walks about 5 times a day. No dizziness, fainting, chest pains, out of breath, not feeling tired. Just
as much energy as ever.At issue is I went to a cardiologist last week and had an ECG and
electrocardiogram, both of which looked fine. I had a Halter monitor which showed some sinus
bradycardia with some 2.7 to 3.4 second pauses.with beats mostly in the 40 to 56 range at night with
6 going as low as 20 at night.. I have been a runner and walker consistenly for the last 58 years. I do
snore at times and wake up suddenly according to my wife and I think I may have sleep apnea
based upon the symtoms i have read about although I do not feel tired during the day and I am not irritable.. Going for a sleep test next week. and a stress test the following week. Also when getting out of bed I do not feel any lightheadedness or dizziness. Same energy as always. Thank you for your thoughts!
Why did the holter get done in the first place?
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Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
Hi sir. Myself akshata. I am case of asthmatic, migraines which are under control. Recently diagnosed with OSA and on CPAP theatment. During night my heart rate goes down to 50-55 and I woke up with sudden jolt or jurk in the chest. Is it worry some or bcoz of bradycardia. Plz reply. Thanks.
Hello, im a 36 year old female my weight is 162 and i am right at 5’7 in height.
I have had quite a bit of weird symptoms going on lately, first off my heart rate drops to high 40s at night while sleeping, and the normal resting heart rate is around 51 while just relaxing. Im not feeling any symptoms other than its extremely hard for me to get up the next day, i usually sleep around 9 hours just because when i do wake up i still feel extremely sleepy.
After waking i get up to start my day and within just the first 30 minutes of being awake my heart rate jumps to about 137bpm,
At this time i start feeling faint and very anxious.
Usually it lasts for about 10 to 15 minutes and then i am able to calm my heart.
After that initial attack my heart rate flip flops from around 60 to 90 bpm during the day.
I had to call ambulance due to it feeling so high and they said my ekg looked normal and that it was showing reading of a healthy heart by the time they got there.
Not certain on whats going on but any advice would be greatly appreciated.
Also i have a pain that is consistsnt just between my shoulder blades, it feels more like a constant strong ache.
When i was younger around 6 years old i was diagnosed with lyme desease but i dont think thats the cause of my symptoms at all.
After CRT-P implantation to my father
While sleeping some times he feel sudden like a jump/jerk or like something poping in his left side moving towards down…
He only feels it , it does not hurt
Even when i place hand in his left side below (stomach) i also noticed
Is it normal ?
I believe the following sentence that appears in the article should be corrected. It currently reads “Patients with sleep apnea, for example, may have very low heart rates at night that can be treated by sleeping the treat apnea.”. Shouldn’t it be “Patients with sleep apnea, for example, may have very low heart rates at night that can be treated by treating the sleep apnea.”?
My husband has moments where his heart beat drops down very slow. It gets very weak and sluggish and irregular, he gets very weak and out of breath and drops to his knees, then it speeds up very quickly and goes faster than normal but still seems weak for awhile.
He suffers from severe panic attacks and anxiety but was on medication for a few years and even while on medication this happened. Now he is no longer on medication and it sends him into panic attacks.
Can this be normal for panic and anxiety patients to have these symptoms? And have you heard of anyone else experiencing anything like this?
Has he worn a monitor to characterize the heart rate and rhythm?
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Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
More curious than anything… 53, reasonably fit. My resting heart-rate is typically in the upper 40’s, or low 50’s. Shortly after strenuous exercise (think 2+ hour mountain bike ride, with heart rate consistently in the 140-160 range), my heart rate will briefly drop well below my normal resting rate. I’ve often seen the lower 30’s, occasionally mid to upper 20’s. No symptoms associated with this- I wouldn’t even know it was happening if I wasn’t wearing the heart rate monitor. In fairly short order, the heart rate returns to its normal resting rate, it’s almost like the recovery just over-shoots the resting target. Is this atypical, or is it something commonly seen?
Here’s a sample heart rate plot (from yesterday) that illustrates this:
https://www.dropbox.com/s/xt1xsb6i27slhx0/hr.JPG?dl=0
You can see the my normal heart rate throughout the day, prior to the ride. Much higher heart rate during the ride. The period of interest is post ride about 1/2 the pre-ride normal. Normal heart rate was resumed about 1-hr after the ride.
Just realized there are no axis labels on that chart… at the lowest post-ride dip yesterday, my pulse rate was 31bpm.
im 33 and evertime im lying in bed my resting is 50 somtimes 47 and when im active diring days it s60 to 80 i am active mom because doing household chores walking everyday is my resting heart rate is good ?
please respond to my message m 33 and evertime im lying in bed my resting is 50 somtimes 47 and when im active diring days it s60 to 80 i am active mom because doing household chores walking everyday is my resting heart rate is good ?
Reply
I am a 56 year old male that was very heavy (350 pounds) and went on an ultra low calorie diet (600 – 800 per day). So far, I have dropped 50 pounds and had stalled about 10 pounds ago, so switched to alternate day fasting (believe my metabolism had slowed to a crawl) with 600 calories a day on fasting and 1500 calories a day alternate. I feel really good. However, I am concerned my resting heart rate is anywhere between 48 – 60 bpm. It does not jump around but is usually fairly constant. I have been walking daily (very brisk and lots of hills) for over a month and go into the gym almost daily for resistance training (used to be an avid and frequent gym person years ago and my heart rate was always sub – 65 or lower back when i was fit). I am not experiencing any issues such as fainting or dizzyness. I am only tired because I usually get only 5 – 6 hours of sleep a night because of work. I cannot think of any symptoms that I am experiencing except the slow resting heart rate. (when I exercise, it can be anywhere between 95 – 128 bpm depending on the exercise, and it normalizes with 30 – 60 min). Should I be concerned?
No obvious cause for concern with what you mentioned particularly as there are no associated symptoms.
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Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
Thank you, a most informative and straightforward paper that explains bradycardia in a format that is easy to understand. Exactly what I was looking for, please keep writing and publishing.
Love your work,
Ross
64 1\2 with 3 heart blockages of 30,30,50%. I am 5’6″ 155 lbs. I run 5 days a week and do track work outs but find I have to walk some due to fatigue or get my heart rate down, not sure which or both. They also said my left part of my heart is enlarged probably due to being athletic. They just had me wear a 24 hour monitor as my resting heart rate is 45. What do you think they are looking for? As far as symptoms I do have some fatigue and when running will occasionally have discomfort in my back below my right shoulder. When I rest it goes away. I have run numerous races and take short walk breaks even in a 5k and people tease me as I can still run a 23 minute 5k and walk 8 times.
I am 40 year old. I have fainting spell once in 2011 then in 2015 and then in 2019. I went to cardiologist when it happened in 2019 and did Echo and 24 hr Holter monitor. Echo came normal and did not get any comment for holter monitor. Just 2 week before, i was trying to see another cardiologist because of the apple watch showing me low heart rate – around 40 at night and sometime reached it at 38 this year. I have around 3 years of data in apple watch. I can see lowest going every year around upper 30 and mostly at night around 40is to 50ish. Also, i noticed it went up to 120-130ish suddent after 40ish BPM. The cardiologist ask me to have holter monitor for 7 days. Results came in and looks like below. Did not yet hear anything back from doctor. Have an appointment with him in next 2 week. Is there anything to worry on it or what i saw on my watch?
No symptoms reported.
The rhythm was Sinus with burden 98.69%, average minutely rate of 77 BPM, slowest minutely rate of 48 BPM, occurring on day 8 at 05:49 and
fastest minutely rate of 159 BPM, occurring on day 3 at 11:15.
The slowest N-N interval within Bradycardia had rate of 40 BPM (1.5s), occurring on day 7 at 22:26. Longest pause with duration of 2.1 s (day 7 at
22:26).
Ventricular ectopic activity consisted of 1508 episodes, of which 1475 were single, 33 were couplets.
Fastest ventricular couplet with rate of 162 BPM (day 3 at 05:11).
Supraventricular ectopic activity consisted of 35 episodes, of which 29 were single, 2 were couplets, 3 were triplets, 1 was longer run.
The fastest episode of Supraventricular Tachycardia had 291 beats, occurred on day 5 at 10:18, lasting 1m 44s with average rate of 167 BPM and
the longest episode had 291 beats, occurred on day 5 at 10:18, lasting 1m 44s with average rate of 167 BPM.
In the past year my teen daughter has twice been told her heartrate is 48 bpm. This was while being checked in by nurse at 2 different doctors offices (at her allergy dr and GI dr). GI doctor said I should talk to pediatrician about it. Ped dr said yes that is low, but that when they check pulse, it is 67 bpm. Dr said for us to check heartrate periodically and if it was below 50 again she would refer us to cardiologist. I got my daughter fingertip pulse-ox monitor so she could check pulse. It is always in the 60-70 bpm range. Her thyroid/CBC tests are normal. She does go through spells where she doesn’t eat much when she is having stress stomache aches, but is a normal weight. Should she see cardiologist? Thank you!
Asalam o alaikum sir,i am 28 years old a few months ago my heart beat was suddenly high 110 resting and i used to take an inderal during the using of inderal my blood pressure was also high 160-110 then the doc advised me to take Dio plus 5/80 after the 5 dose of D plus my blood pressure suddenly down to 90/60 and pulse rate 61 beats per min .all the tests ekg ecg rfts cholestrol are normal .now a days my blood pressure remain 100/60 tp 110 and my pulse rate 60 per min in resting when i standing or eating heart beat increase 40 t0 50 beats per min so should i worry about this situation?
Doc,
Im 15 years old. When wearing an Apple Watch, I noticed that it said my resting heart rate was 54 BPM. Im very anxious that this number is too low for me. I’ve been having some dizziness, but that occurs even when I’m standing up and when my heart rate is in about the 80s, I believe. I think its just from my anxiety, because I’ve been feeling very anxious lately and even had a few panic attacks. Also, I’ve been feeling rather tired some days, which I also believe is related to the anxiety I’ve been experiencing, because I also experience depersonalization. Im not very active. I walk about 2 miles in school everyday and climb about 6 flights of stairs, I believe. I’ve had an echo, EKG, and holter monitor. The doc said I’m fine, and even healthy. When sitting around the house, my heart rate is usually in about the high 70s to 80s. But sometimes, I think it goes to the 50s as well. When I asked my doc what my resting heart rate was according to the holter, he told me it was about 80, I believe. I’m very confused because when laying down at night in bed I’m almost sure my heart rate goes to the 50’s and an Apple Watch even confirmed it. I can almost say for sure it goes to the 50’s. I’ve checked my pulse several times. Im very scared. Can you please reassure me , doc? Thank you so much!!!
46M 200lbs weight BP on mid 130s to 80s (sometimes goes up). I bike frequently road\mtb. when pushing it hard i can hit 180bpm but typically my average for a ride is 130s to 140s. I do ride hard. After 10 days overseas i came back yesterday, and went for a MTB ride. AVG HR 115 max 160 and then i stopped for my friend who needed a breather, and lights went out and i was out for 2 seconds. I stopped riding, and I am a little concerned. I had a decent breakfast, and was drinking water w\BCAA during the ride. While overseas i went to the gym 5 out of the 9 days, and one hiking 1 of the days to keep in shape (also experienced severe cramps on my right leg during the hike (mostly steps climbing a mountain)
Oh my resting HR is on the 70’s
Thank you for the very informative article. I am 75. My resting heartbeat, taken from time to time, is in the 52-56 range. I am somewhat active. I don’t have any of the symptoms you mention thought I suppose there is a possibility of sleep apnea. I usually – almost always – sleep about 6 hours a night which seems adequate as I get up and get busy – never tired in the morning. I always assumed a low heart rate was a sign of being fit, but now I am not sure. I had a full ekg and stress test with ultra sound (?) about 3 years ago. All seemed fine, but I recall that I was not able to get my heart beat elevated sufficiently for them to perform the ultra sound – so they had me running to get there. Anyway, any suggestions? Should I see a specialist and get reevaluated. (heart rate just now taken – 53). Thank you for anything you can suggest.
In the absence of other symptoms, and reassuring prior testing with no new issues, a low heart rate alone in the 50’s may be perfectly normal.
You can follow our twitter at @MustafaAhmedMD
Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
Doc,
Im 15 years old. When wearing an Apple Watch, I noticed that it said my resting heart rate was 54 BPM. Im very anxious that this number is too low for me. I’ve been having some dizziness, but that occurs even when I’m standing up and when my heart rate is in about the 80s, I believe. I think its just from my anxiety, because I’ve been feeling very anxious lately and even had a few panic attacks. Also, I’ve been feeling rather tired some days, which I also believe is related to the anxiety I’ve been experiencing, because I also experience depersonalization. Im not very active. I walk about 2 miles in school everyday and climb about 6 flights of stairs, I believe. I’ve had an echo, EKG, and holter monitor. The doc said I’m fine, and even healthy. When sitting around the house, my heart rate is usually in about the high 70s to 80s. But sometimes, I think it goes to the 50s as well. When I asked my doc what my resting heart rate was according to the holter, he told me it was about 80, I believe. I’m very confused because when laying down at night in bed I’m almost sure my heart rate goes to the 50’s and an Apple Watch even confirmed it. I can almost say for sure it goes to the 50’s. I’ve checked my pulse several times. Im very scared. Can you please reassure me , doc? Thank you so much!!!
Doc I am 15 years old. When lying in bed at night, my heart rate has went down to the high 40’s- Specifically 45,47,48, etc. It also goes this low in the morning when I wake up and go downstairs to lie in another bed. There aren’t any noticeable symptoms when the heart rate gets low. I’ve been evacuated by a cardiologist and had an EKG, holter, and echo. Everything came out good and the doc said I was healthy. During the day, I am quite tired and dizzy but I believe this is due to anxiety because I only had these symptoms when I began getting anxious. Now, my heart rate rises up fast when excercisng. For example, by doing only about 10 pull-ups I believe, my heart rate rises up to 130 BPM I believe. What do you advise me doctor? Is this normal? Thanks a lot! I would really like an answer as I’m very anxious about this, and am afraid to fall asleep at night. Thanks!
Please Doc, I really need an answer. ^^^^
Daniel, you are perfectly fine. 130 is not high for a 15 year old, you can go much higher. In fact you cannot exceed your own body’s limitations, it’s a wonderful machine! Try to see what you can get, once i measured 187bpm on a spinning machine at steep uphill setting. then you can count the time it takes for your pulse to come down again, the faster pulse drop the better 🙂
Your pulse at night is also perfectly fine. While at rest the body require less oxygen.
People who has a heartrate that is too low, will suffer oxygen depletion, their lips and fingernails will turn blue, they will also suffer dizzyness, weakness, fatigue, severe chest pain and fainting. For chest pain it’s normal in youth to experience this and in adults it’s more likely to be stress induced pain, so the chest pain in it self is not a symptom ok 🙂
You are 15, you are in good shape, you should free your self from anxiety ok! Dont worry and for your sleepyness, some morning workout will serve you well. I hope you are already feeling better and i would not write to you if i was not sincere!
Hi, This morning after I just woke up I did my blood pressure. my pulse was 53. then check it 15 mins later it was 67. should I be concerned?
I am in my 30s I work nights and am very active in my job role as it physical. even tho I am over weight .
thanks
I am going on 81. I work out (6) days a week. My lowest pulse rate has been 41, I take a medicine for an irregular heart rate, medicine to raise my blood pressure to 130 which has stopped dizziness and falls for about one year now. I also take thyroid medication. I feel no symptoms of anything and my heart doctor said I have a strong heart and he does not want to see me for another year. Is it most likely that my low pulse rate is related to the medicines? You have said the heart may pump more blood when the pulse rate is so low.
I am a 56 year old man and a long distance runner. My family history includes heart disease. After 12 years of running with a resting heart rate of 40, I quit exercising about 4 years ago. My resting heart rate increased to 48. At the start of 2019 I began running again and I run about 4 times a week with runs ranging from 6 to 20 miles, averaging 40 to 50 miles a week. My resting heart rate is down to 39. Around May of 2019, I began experiencing episodes of my heart rate dropping to 33 to 37 during the day while not at rest. I explain the symptoms as feeling off or “fuzzy”. I had a favorable report from a heart cath. Also wore a monitor for a week and nothing remarkable. Episodes are very random but very noticeable. Recently, the frequency has increased. An echo of my carotid arteries was clear. My resting heart rate is generally around 39 dropping to 35 or so during a deep sleep (normally 10-15 minutes).
The episodes are becoming problematic. My cardiologist isn’t concerned. What can explain the episodes? Should I be concerned?
Thanks for your response.
The way in which bradycardia, a slow heart rate manifests clinically can be with passing out, dizziness, lethargy or fatigue. Typically a slow heart rate will accompany these, and therefore its important when wearing a monitor to keep a meticulous symptoms diary. Im assuming also that your hear rate responds adequately to exercise and rises appropriately. When you have these episodes a blood pressure diary is important also. If the episodes are becoming problematic, rediscuss with your heart dr or consider the opinion of an electrophysiologist. The heart rate may or may not be related.
You can follow our twitter at @MustafaAhmedMD
Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
Doc I am 15 years old. When lying in bed at night, my heart rate has went down to the high 40’s- Specifically 45,47,48, etc. It also goes this low in the morning when I wake up and go downstairs to lie in another bed. There aren’t any noticeable symptoms when the heart rate gets low. I’ve been evacuated by a cardiologist and had an EKG, holter, and echo. Everything came out good and the doc said I was healthy. During the day, I am quite tired and dizzy but I believe this is due to anxiety because I only had these symptoms when I began getting anxious. Now, my heart rate rises up fast when excercisng. For example, by doing only about 10 pull-ups I believe, my heart rate rises up to 130 BPM I believe. What do you advise me doctor? Is this normal? Thanks a lot! I would really like an answer as I’m very anxious about this, and am afraid to fall asleep at night. Thanks!
I am 35 year old female. In 2017 I was dx with bradycardia with low bp (heart rate dropping to 45) after recurrent episodes of syncope. I was hospitalised but no cause was found.
In 2018, I was sent for Tilt testing which was positive for Neurocardiogenic syncope.
As advised by the cardiologist, I needed to make lifestyle changes in order to keep the BP up as there is no treatment for my condition .
After a year of trying to change my lifestyle around my condition, I continued to have dizzy fainting spells and severe weakness which has affected my quality of life.
End of January 2020,I had a syncope episode at home and again in the GP rooms.The GP referred me back to the cardiologist suggesting that a pacemaker be considered as the symptoms are the same even when BP is in the normal range.
On seeing my cardiologist again, I was told that they could insert a pacemaker but with no guarantee.
From this article it appears to me that you have a much greater understanding of this type of condition than the cardiologists I have seen in South Africa.
Your advise will be highly appreciated.
I am about to lose my mind, Ive been to numerous Dr.s and emergency rooms also cardiologists.
I’m drowning in debt being told they cant find anything. my resting heart rate is in the 50,s im 41 non smoker weight 230 ht 5’9
ive done all the scans and blood tests. i will get a rush of what feels like a heart attact for about ten mintues then it passes…im lost on what my options are…
Hi, from as early as I can remember I have had a low pulse and just ignored it.
I am 47, male, North Indian origin. Pulse averages around 46bpm. Resting down to 40, after purchasing an Apple Watch noticed my pulse will drop as low as 35 when resting or during sleep.
6’1” tall, slim build about 86kg weight.
I have had an ecg on several occasions and have been told everything looks ok. I have informed the doctors that the last time I probably really exercised was in my mid twenties.
Would like your opinion on this please
Hi, My resting pulse used to be in the 40s and drift into the upper 30s during the night, lately it is in the upper 30s drifting into the mid 30s at night. I am 65 and run 7+ miles a day. I have no symptoms but wonder if I am hypothyroid. I am having trouble keeping my weight at 105, my normal weight, without skipping meals
I was diagnosed with high blood pressure a few weeks ago 178/110, chest pain took me to emergency room. Did many tests after in following days too, EKG, cardiac echogrtam, stress test, d-dimmer test, tick born test. Pain (numbness) has developed in left foot and hand, pain last night was so bad in foot I went back to hospital today, my bp was normal but heart rate was 32 they recorded. The did an EKG on spot and it was fine. I am home now and heart rate has gone as low as 29 bpm, seems to fluctuate a lot but its been at 29 3 times in last hour but then goes to about 65. They are putting a heart monitor on me but not until monday, its now Friday. unsure how urgent this is, I have persistent chest pain and slight headache but every test comes back negative. I feel great other than that… lol
Hello Dr and everyone on this site,
So I’m currently 38 years old. For most of my life I’ve been very active. Played soccer for many years, exercising, and have been eating well for the most part of my life.
For about 5-6 years now I’ve had some discomforting chest pains in my heart area (left side of ribs, heart location, and middle of chest). Usually, I would get these chest pain episodes during the night when sleeping and I would be awaken by it. I have been seeing my family practitioner and in the beginning she order blood test, BP, EKG, stress testand ultrasound. All to come back good. EKG had a RBBB on it and my doc said not to worry as test results came back good so there is no need to worry. Her diagnosis was either heartburn, or some sort of nerve damage within my pectoral and rib cage region. Fast forward to 2020 and one day at work I had no chest pain but I experienced some dizziness that last about 15-20 mins. I little bit of increased heart rate (due to the fact that I was getting worried)but no other symptoms. I checked myself into the ER and they order a blood test, EKG and chest x-ray. All came back fine except EKG had the same RBBB and they found a showdown within my trachea region that end up being a slightly enlarged ascending aorta at 3.2cm which they concluded that it’s a normal variant considering my active lifestyle. I continued to have episodes of chest pain in the same heart region area and it’s becoming more frequent. My practitioner referred me to a 2nd cardiologist for another ultrasound and EKG and all came back good. Cardiologist again concluded that this pain has nothing to do with the heart. I should mention that I had to also wear a heart monitor for 72 hrs but we haven’t discussed the results yet. Appointment is coming up soon in few days.
I started to monitor my HR and my heart rear recovery after jogs. My HR is fine as I’m able to get it up to 170 during my runs and my heart rate recovery after 3 mins would be around 50-55 beats per minute. My resting HR during the day will be around 58-52 BPM sometimes I’ve seen 48 bpm. Now during my sleep I noticed that my heart rate dips to around 45-39 BPM and lately I’ve been getting discomfort in the heart area as well at night.
I should include that I do live a healthy lifestyle, but occasionally, like most people I like to drink a few alcoholic beverages and wine on weekends. Especially during gatherings. I’m not sure if this plays a factor but I do like to enjoy and treat myself from time to time.
Should I be worried about my chest pains in my heart region considering that my heart beats dips between 45-39 BPM when I sleep?
IVe been active my entire life. I have a rapid heart rate. Typically 80-120 at rest. Recently I’ve been dizzy, nauseous and fainting. I’ve have fainted approximately 30 times in the last year and a half. I have periodic episodes of SVT PVC and PACs but not outside the realm of normal. I also have BP spikes (156/104) for which I have been put on metoprolol 25 mcg twice a day. After receiving a Apple Watch for Christmas I’ve noticed that I faint when my HR drops to 40 from 90-120 within a couple minutes span. They have not yet successfully capture this on either Loop or holter monitors. What should I be doing to aid this or who should I be consulting with and what should I be asking them?
Asalam o alaikum sir,i am 28 years old a few months ago my heart beat was suddenly high 110 resting and i used to take an inderal during the using of inderal my blood pressure was also high 160-110 then the doc advised me to take Dio plus 5/80 after the 5 dose of D plus my blood pressure suddenly down to 90/60 and pulse rate 61 beats per min .all the tests ekg ecg rfts cholestrol are normal .now a days my blood pressure remain 100/60 tp 110 and my pulse rate 54-56 per min in resting when i standing or eating heart beat increase 40 t0 50 beats per min so should i worry about this situation?
I have an AFib , enlarged left atrium, so enlarged that my doc said that he had never seen an atrium of that size in his 25 years long career.He got really excited when he saw it, almost looked happy. He prescribed bisoprolol, Xarelto, enalapril. My heart rate is in low 40s and have no symptoms. Left ventricular ejection fraction above 60%.I am 49 and lift weights, mostly deadlifting. The other doctor told me that because my heart is strong (EF >60%) and I don t feel dizzy or anything, there is no need for a pacemaker.
Hi, my heart rate dropped under 50bpm a few times the past two years. But suddenly the past 4 days it drops to under 50bmp every night several times. My watch wake me if this for 10 minutes. Last night it happened 5 times. My concern is that I am very unfit and the fact that it happens now every night. Is there reason for concern? I am a 44 year old woman with absolutely no health problems except for being over weight and unfit
I am a 43 year old female. For a few months now my heart rate has been very irratic. It will go from the 70s and 80s down to the 10 to 15 range. It stays at the lower range for a lot longer than I feel secure about. It can stay at 10 bpm for up to 10 seconds. Sometimes longer. Then go right back to the 70s and 80s only to go back down to 10 within a few seconds. Is this normal? Should I be concerned?
If you feel your heart rate is going to 10 this is likely a miscount. I would recommend a monitor placed to confirm.
You can follow our twitter at @MustafaAhmedMD
Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
“by sleeping the treat apnea”
I don’t think so!