Most researchers consider bradycardia to be a heart rate less than 60 beats per minute (bpm). However, for athletes, a normal resting heart rate of less than 60 bpm is not a problem.
- Bradycardia is a condition where the heart is beating in a (sometimes irregular) rhythm that is too slow to maintain a sufficient supply of oxygenated blood throughout the body.
- A slow heart rate is common under various circumstances and does not necessarily require treatment unless it causes symptoms.
- Nonetheless, some patients, even if asymptomatic, may require interventions to prevent life-threatening complications.
Some people with bradycardia have no symptoms at all, while others may experience episodes of:
- Shortness of breath
- Dizziness or fainting
- Chest pain
- Disturbed sleep
- Palpitations (feeling that your heart is racing or that your heartbeat is irregular)
- Confusion or memory loss
A slow heartbeat may be associated with symptoms related to other body systems, such as:
- Coughing up clear, yellow, light brown, or green mucus
- Nausea with or without vomiting
A slow heartbeat may be a symptom of a life-threatening condition in some cases and should be evaluated immediately in an emergency setting.
Seek immediate medical attention (call 911) if you or someone you are with has a slow heartbeat accompanied by any of the following life-threatening symptoms:
- Chest pain or pressure
- Fainting or change in the level of consciousness or lethargy
- High blood pressure
- Nausea with or without vomiting
- Pain in the back, neck, jaw, or stomach
- Shortness of breath, difficulty breathing, labored breathing, wheezing, or choking are examples of respiratory or breathing problems.
Even routine activities, such as going up a few stairs or walking, can cause symptoms such as shortness of breath.
Symptoms of bradycardia usually appear gradually. People sometimes mistakenly believe that the symptoms are caused by aging rather than a heart problem.
What may be the potential causes of bradycardia?
Bradycardia is a type of cardiac arrhythmia that can be caused by a variety of medical conditions. There are several possible causes for an abnormally slow heart rhythm.
The causes of bradycardia may include:
- Heart disease, heart attack, or myocarditis (infection of the heart)
- Congenital heart defect
- Heart surgery complication
- Hypothyroidism or chemical imbalance
- Inflammatory diseases such as lupus or rheumatic fever
- Sleep apnea
- Certain medications
Because bradycardia is frequently associated with heart disease, it shares some of the risk factors. Age is a major risk factor, and bradycardia becomes more common with age.
Other risk factors of bradycardia include:
- High blood pressure
- High cholesterol
- Excessive alcohol consumption
- Recreational drug use
- Stress or anxiety
These causes are further classified as two types of bradyarrhythmias:
How is bradycardia usually diagnosed?
The first step in diagnosing bradycardia is determining whether the slow heartbeat is the source of the symptoms. The doctor may start by interviewing you and performing a physical examination.
Your doctor may order a variety of diagnostic tests based on your symptoms, which may include:
- Electrocardiogram (EKG/ECG)
- The electrical activity of the heart is recorded during this test.
- Holter monitor
- A portable, battery-powered ECG/EKG that is worn for a few days and provides your doctor with continuous data about your heart's electrical activity.
- Exercise stress test
- A treadmill or stationary bicycle test that measures heart, lung, and muscle function during physical activity.
- An EKG/ECG is attached to you to record electrical activity in the heart.
- Echo stress test
- This test employs sound waves to produce moving images of your heart at rest and after stress.
- Electrophysiology study
- An invasive test in which the doctor inserts a small tube through a blood vessel into the heart to assess the electrical system's health and determine whether bradycardia treatment requires a pacemaker.
Other tests, depending on the results of your physical examination, may be required to rule out medical illnesses that cause bradycardia.
What are the treatment options for bradycardia?
Treatment for bradycardia varies depending on the severity, frequency, and cause of the slower heart rate.
The treatment of bradycardia is based on three major factors, which are as follows:
- The type of electrical conduction problem
- The severity of the symptoms
- The underlying cause of bradycardia
Treatment is usually not required for slow heart rate unless the symptoms are severe or recurring.
- If there is an underlying cause for the bradycardia, that condition is treated.
- Some medications used to treat other conditions can cause bradycardia. Your doctor will review your medication history and may prescribe alternative medications.
- In the case of severe bradycardia, an artificial pacemaker can aid in the treatment of the condition by speeding up the heart rhythm as needed.
Bradycardia can be prevented in two ways:
- Lowering the chances of developing heart disease
- Monitoring pre-existing heart disease by adhering to the proper treatment plan
Risk factors can be eliminated by following these steps:
- Maintain a healthy diet and exercise regularly
- Keep a healthy body weight
- Maintain healthy blood pressure and cholesterol levels by abstaining from smoking and drinking
- Prevent drug abuse
- Stress and anxiety management
- Regular health examinations and follow-up visits
- Inform your doctor of any changes or other symptoms as soon as possible.
Bradycardia is sometimes asymptomatic and does not result in any complications. However, depending on how slow the heart rate is, if the condition is not treated, the patient may develop complications.
Untreated severe, prolonged bradycardia can lead to heart failure. The complication associated with bradycardia is syncope, a condition characterized by loss of consciousness or fainting associated with high blood pressure and chest pain (Angina pectoris).
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What is Bradycardia? https://www.webmd.com/heart-disease/atrial-fibrillation/bradycardia
Bradycardia (slow heart rate): https://www.barnesjewish.org/Medical-Services/Heart-Vascular/Arrhythmia-Heart-Rhythm-Disorders/Bradycardia-Slow-Heart-Rate
Bradycardia: slow heart rate: https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/bradycardia--slow-heart-rate
Sinus bradycardia: https://www.ncbi.nlm.nih.gov/books/NBK493201/
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