Understanding a Slow Heart Rate
It's common to experience a slow heart rate as you get older, but it's also something that your doctor needs to monitor. Find out what a slow heart rate means for your health, and when it's time to seek treatment.
It’s common for everyone’s heart beat rate to slow down at rest, but some people have a chronically slow heart rate that causes symptoms such as fatigue and light headedness.
This condition is called bradycardia, and it’s more common as you age. Mild cases of bradycardia don’t have symptoms, but in severe cases it can cause chest pain, shortness of breath, and may even lead to cardiac arrest.
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A normal heart beat rate is between 60 and 100 beats a minute, says Joshua D. Moss, MD, a cardiologist at the Heart Rhythm Center at the University of Chicago Medical Center. Bradycardia is defined as having a heart rate of less than 60 beats a minute. In reality, you can have periods when your heart beat rate goes below 60 and not have bradycardia, Dr. Moss says. It can happen when you’re sleeping, or it can occur in highly conditioned athletes when they’re at rest.
How Bradycardia Is Detected
You may be prompted to find out if you have a slow heart rate if you have certain symptoms. However, some people with the condition don’t have any symptoms.
Typical symptoms include excess fatigue — to the point of feeling exhausted from walking or climbing stairs — and light headedness. When bradycardia is more severe, you may experience shortness of breath, chest pain, and fainting. If severe bradycardia goes untreated, it could lead to cardiac arrest, meaning the heart stops beating, and that can lead to death.
Not everyone with bradycardia has symptoms. Your doctor may discover a slow heart rate during a routine office visit — another good reason for regular check-ups — and will probably send you for an electrocardiogram and other tests, Moss says. If the tests find that you do have mild bradycardia and you don’t have symptoms, your doctor will keep an eye on your condition, but you may not need treatment.
What Causes Bradycardia
Your heart has a built-in pacemaker called the sinoatrial (SA) node that tells your heart how quickly to beat. As you age, the sinoatrial node can slow down, and that slows down your heart beat rate. Another cause of bradycardia is when the atrioventricular (AV) node stops working well and leads to a slower heart rate, Moss says. The AV node, in normal circumstances, receives the electrical impulse from the SA node, and carries the impulse throughout the bottom chambers of the heart. This electrical impulse is designed to stimulate mechanical contraction, which in turn, pumps blood throughout the body.
The most common cause of problems with the SA or AV nodes is aging. An SA node that stops firing properly typically begins when people are in their seventies, although a congenital problem can cause it to happen in younger people.
Heart disease can accelerate these problems, so maintaining good heart health by exercising and eating a healthy diet can keep your heart beat rate in a healthy range.
In some cases, a slow heart rate can be the result of blood pressure medication, which can lower your heart rate.
How Bradycardia Is Treated
A bradycardia prognosis depends on the cause. If it’s a serious dysfunction of the AV node that’s causing the slow heart rate, doctors recommend getting a pacemaker, whether or not you’re having symptoms. “We worry that in such cases there’s a risk that it can get worse without warning and lead to cardiac arrest,” Moss explains.
But it’s more common for elderly patients to have a dysfunction of the SA node or a less severe problem with the AV node, Moss says. In these situations, the recommendation is based on symptoms. If symptoms are mild and you can do the activities that you want to do, then your doctor may decide to watch the condition over time. If not, you may need a pacemaker.
If your blood pressure medication is causing bradycardia, your doctor may consider changing the drug. But if you must be on that specific medication, you may need a pacemaker as well.
Fortunately, bradycardia is generally not serious. As long as your doctor is aware of your slow heart rate and you get any treatment you need, you should still be able to do all of the activities you love to do. more