What Your Heart Rate Can Signal
During cardiac assessments, experts often take into account resting heart rate, how quickly it increases during physical activity, heart rate recovery and heart rate variability, said Daniel Cantillon, the associate section head of cardiac electrophysiology and pacing at the Cleveland Clinic.
For most people, it is considered normal to have a resting heart rate when the heart is pumping the lowest amount of blood you need between 60 and 100 beats per minute, according to the American Heart Association. Generally, a lower resting heart rate is associated with higher cardiovascular fitness. Some athletes, for instance, have resting heart rates well below 60.
A low resting heart rate can indicate a heart thats physically fit, Martin said. If your hearts in good shape, with each beat of the heart then youre pumping blood efficiently to the rest of your body.
If, on the other hand, a person at rest has a high heart rate, that indicates that the hearts working harder than we would expect it to have to work at that state, he said.
Another marker that can be tracked with technology is heart rate variability, or a measure of the variation in time between each heartbeat. A fair amount of heart rate variability, Cantillon noted, can indicate a healthy autonomic nervous system.
How Is Bradycardia Diagnosed
When you see your doctor, they will measure your heart rate. Your heart rate might have returned to normal, so its a good idea to keep a record of when you experience bradycardia or related symptoms.
Your doctor will also need to work out the cause of your bradycardia. They will ask about your symptoms and your medical and family health history, and will examine you. Tests, such as an electrocardiogram, or ECG, might be done to check your heart. Depending on what is found, you might need further tests such as a stress test.
Can You Die From Bradycardia
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.
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How Is Bradycardia Treated
How bradycardia is treated depends on what is causing it. Treatment also depends on the symptoms. If bradycardia doesn’t cause symptoms, it may not be treated. You and your doctor can decide what treatment is right for you.
- If damage to the heart’s electrical system causes your heart to beat too slowly, you will probably need to have a pacemaker. A pacemaker is an implanted device that helps correct the slow heart rate.
- If another medical problem, such as hypothyroidism or an electrolyte imbalance, is causing a slow heart rate, treating that problem may cure the bradycardia.
- If a medicine is causing your heart to beat too slowly, your doctor may adjust the dose or prescribe a different medicine.
The goal of treatment is to raise your heart rate and relieve symptoms. For certain types of bradycardia, treatment may help prevent serious problems. These problems include fainting, injuries from fainting, and even death.
Potential Causes Of Low Heart Rate
Generally, a slower heart rate when you are at rest is a sign of good health. Bradycardia can result from several positive or neutral causes that shouldnt warrant any worry. Some of these include:
- High fitness levels
- The impact of regular meditative breathing
- A genetic predisposition for a slower heart rate
- The side effect of beta-blockers and other heart-related medications
Do You Know: Bradycardia that stems from the use of beta-blockers and other heart-related medication, is often reversible.
Suppose your heart rate is falling to dangerous levels because of the medication and experiencing symptoms like fatigue, weakness, lightheadedness, shortness of breath, and dizziness. In that case, you should consider stopping the medicine immediately until you consult with your doctor.
In most cases, stopping the medication will immediately reverse the symptoms.
However, in other cases, bradycardia may stem from other severe, more worrying, and potentially more harmful causes like:
- Hypothyroidism and other hormonal and metabolic problems
- Heart attacks
- Sick sinus syndrome, congestive cardiomyopathy, node damage, and other forms of heart disease
In all of these severe cases above, a low heart rate is a cause for concern, as it can signal potentially dangerous or even fatal conditions that require immediate attention. So, how can you tell whether your low heart rate stems from a positive, unthreatening source or a more critical, potentially life-threatening condition?
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Low Diastolic Pressure: No Symptoms
“When your systolic blood pressure gets too low, it can manifest as lightheadedness, fainting, and weakness. But low diastolic pressure by itself doesn’t have any symptoms,” says Dr. Paul Conlin, professor of medicine at Harvard Medical School and chief of medicine at the VA Boston Healthcare System.
One of the new studies, which analyzed the medical records of more than 11,000 adults over a period of three decades, found that people who had low diastolic blood pressure were twice as likely to have subtle evidence of heart damage compared with people whose diastolic blood pressure was 80 to 89 mm Hg. Low diastolic values were also linked to a higher risk of heart disease and death from any cause. The findings appeared in the Aug. 30, 2016, Journal of the American College of Cardiology.
Another study, published in The Lancet, involved more than 22,000 people with heart disease, whom researchers grouped according to their blood pressure readings. People with well-controlled blood pressure values were considered the reference group.
Not surprisingly, people with high systolic blood pressure were more likely to experience heart attacks or strokes, be hospitalized with heart failure, or to die compared with people in the reference group. But the same was true for heart attacks, heart failure, and death in people with low blood pressure .
Can Resting Heart Rate Be Too Low
While less common, some people may have a resting heart rate that falls lower than 60 beats per minute.
“When a person’s heart muscle is in excellent condition, it doesn’t have to work as hard to keep a steady beat. Therefore, people who exercise frequently and are very physically fit can have a resting heart rate that falls below 60 beats per minute. In fact, a trained athlete’s resting heart rate can be as low as 40 beats per minute,” explains Dr. Chebrolu.
Additionally, medications, specifically beta blockers, can also slow your heart rate.
“The time to worry about a low heart rate is if you’re not very active and you’re not taking medications but your resting heart rate frequently falls below 60 beats per minute, especially if you’re also experiencing dizziness, shortness of breath or fainting,” warns Dr. Chebrolu. “This can be a sign of bradycardia a slower than normal heart rate that can lead to poor oxygen flow to your vital organs.”
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How Will Your Doctor Find And Treat Bradycardia
Your doctor will ask about your usual activities and conduct a physical exam.
He or she may use an electrocardiogram to measure the electrical signals in your heart . A wearable, 24-hour monitor can tell your doctor how your heart performs over time.
Once your doctor decides you need treatment, he or she will try to rule out medications or other pre-existing conditions as causes. Sometimes changing medications or similar strategies can solve the problem.
If not, implanting a pacemaker via minimally invasive surgery is the only option to speed up your heart rate, Dr. Baez-Escudero says.
He notes that bradycardia isnt often an emergency, so doctors have time to choose the right treatment.
In general, bradycardia allows time for us to evaluate the condition and rule out if any other condition is responsible, he says. Then, we can adjust medications or take other steps if we need to.
When Should I See My Doctor
If you have a heart rate under 60, and youre arent exceptionally fit, its important to see your doctor. It might help to make a note of the times you notice your heart is slow, and how youre feeling at the time.
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Why Does Bradycardia Happen
The most common cause for bradycardia is a malfunction in the hearts natural pacemaker, the sinus node. It controls how quickly the top and bottom heart chambers pump blood through the body. Another cause is atrioventricular block , in which the top and bottom chambers dont communicate well and the heart rate drops as a result.
Its like having virtual electrical cables and wires inside the heart, Dr. Baez-Escudero says. And, they deteriorate as we age. Common medications that are used in older populations can also often make bradycardia more significant.
In fact, age is the most common risk factor for developing bradycardia. The condition is most common among men and women over age 65.
Illness or other conditions also may prompt it. These other causes include:
- Heart attacks due to coronary artery disease.
- Bacterial infection in the blood that attacks the heart.
- Inflammation of the heart muscle.
- Low thyroid function.
- Too much potassium in the blood.
- Certain medications, including beta blockers and antiarrhythmics.
Congenital heart defects, diabetes or long-standing high blood pressure all may make bradycardia more likely, Dr. Baez-Escudero says.
When To Worry About Low Heart Rate
Our heartbeat is one of our most essential biomarkers. One of the most significant statements to the significance of this bodily function is its recognition world over as one of the principal medical markers for the presence of life.
However, the importance of your heartbeat extends beyond acting as a notification that you are still alive.
The heartbeat is a rhythmic contraction of the cardiac muscles. These muscles then control the pumping of oxygenated and deoxygenated blood around your body. Consequently, the rate of your heartbeats can be a direct measure of the function and overall health of the organ.
Furthermore, in the multifaceted and interconnected system that is the body, a variance in heart rate levels can be an indicator for a host of conditions, including the adrenaline rush from exercise or fear, hormonal imbalances, psychological issues, or other underlying medical problems.
With heart rate, when you are at rest, less is often always better. Generally, a lower resting heart rate indicates that the organ is performing more efficiently than average. Lower heart rates are usually standard among well-trained athletes and people with high cardiovascular fitness levels.
A lower rate implies that your heart does not have to overexert itself to provide the rest of your body with the minimum required amount of oxygenated blood.
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How To Maintain A Normal Range Of Heart Rate Variability
Although genetic factors have a high say in this matter one can maintain a normal range of heart rate variability by maintaining proper health, sticking to a fitness regime, managing stress, and following recovery methods like meditation. As a thumb rule maintaining a stress-free life is the base rule for a normal range of HRV.
Although exact heart rate variability range is a tricky one to answer knowing it is good as you can be aware of your health condition by tracking HRV.
Sudheendra is a passionate blogger for 8 years and holds a Degree in Journalism & Mass Communications. His writings particularly focus on health, medicine, diet & lifestyle. For him, everything that interlinks and relates to health & medical world entices him. His write-ups aim at educating people not by just giving facts but by infusing human touch.
When To Worry About A Low Heart Rate
One complication related to bradycardia is a condition called syncope. It means a loss of consciousness , usually due to insufficient blood flow to the brain. A low pulse rate can compromise your circulation. Your heart may not pump fast enough to keep a healthy flow of blood up to your brain and throughout your body. Fainting, of course, can lead to dangerous falls and bone fractures.
The most common symptoms of a low heart rate, according to the American Heart Association, are fatigue, confusion, dizziness, shortness of breath, especially during exercise.
To compensate for a slowly beating heart, your heart muscle might try to pump harder to keep up with your bodys demand for oxygenated blood. This can lead to high blood pressure and even heart failure, if your heart muscle works overtime for too long a period. A low pulse rate is also paired sometimes with low blood pressure, a condition known as hypotension. Low blood pressure is also a cause of syncope.
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Slow Heart Rate Questionnaire
Heart attacks occur because of a decrease in blood flow to the heart. This is caused by a blockage in one of the hearts major blood vessels. In about 15% to 25% of heart attacks, the blood vessel thats blocked also supplies oxygen to your hearts electrical system. When the heart doesnt get enough oxygen, you may experience a slow heart rate.
Call 911 or go to the ER right away if you suspect youre having a heart attack. Treatment depends on the severity of the heart attack. It may include a combination of medications, stents , and surgery.
Treating a heart attack usually restores normal heart rate. However, a small percentage of people may need to get a pacemaker to control their heart rate.
How Slow Is Too Slow
Doctors consider a heart rate below 60 beats per minute as low, Dr. Baez-Escudero says.
If you have bradycardia, youll have a sustained heart rate below 60 even when youre awake and active. A normal range is from 60 to 100 beats-per-minute while awake. The heart rate can also slow down normally while we are asleep to 40 to 60 beats a minute.
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What Is Resting Heart Rate
Even if you don’t always feel it, your heart is always beating.
If your heart rate is the number of times your heart beats per minute, your resting heart rate, then, is the number of times your heart beats per minute while you’re at rest.
“It’s normal for your resting heart rate to differ from someone else’s, and it’s also normal for your own heart rate to vary slightly throughout the course of the day,” says Dr. Chebrolu.
Factors that can affect your resting heart rate include:
- Having heart disease, diabetes or higher cholesterol
- Emotions you experience
- External conditions, including air temperature
“Generally speaking, though, a normal resting heart rate typically ranges between 60 to 100 beats per minute in adults,” adds Dr. Chebrolu.
Also, don’t forget a normal heart rate does not imply a normal blood pressure.
How Is Resting Heart Rate Calculated
Measuring your resting heart rate is as easy as checking your pulse, which can be felt on the side of your neck or the underside of your wrist .
While sitting down and once you feel your pulse count the number of beats you feel over the span of 30 seconds . Multiply this number by two to calculate your heart beats per minute.
“To get an accurate representation of your resting heart rate, repeat this process a few times and over the course of a few days,” adds Dr. Chebrolu.
She also advises against checking your heart rate immediately after a stressful event, strenuous activity or consuming caffeine, which can lead to temporary elevation in your heart rate.
Additionally, most wearable fitness trackers and smart watches provide insights into your heart rate. And since these devices collect measurements throughout the day, they’re a simple way to effortlessly monitor your average resting heart rate.
“The heart rate measurements taken by wearable devices may not be as reliable as checking your pulse by hand, but they can help you track general trends and spot changes in your resting heart rate,” says Dr. Chebrolu.
And while some smartwatches now come with an ECG feature that can help monitor for heart rhythm issues, these devices alone cannot detect a life-threatening arrhythmia, such as atrial fibrillation .
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Other Heart Electrical Issues
The heart communicates by sending electrical signals. For example, one chamber of the heart sends electrical signals to another, telling it how and when to squeeze blood into the next chamber.
The pacemaker helps regulate this electrical system. If the heart is not able to send the correct electrical signals, due to a blockage or heart disease, it can cause bradycardia.
Complete heart block is a type of electrical issue that makes it impossible for electrical signals to travel from the atria the top two chambers of the heart to the ventricles, which are the bottom two chambers. In complete heart block, the top two chambers may have totally different rhythms to the bottom two.
Bradycardia: How Low Is Too Low
While a normal sleeping heart rate can dip below 60, the Cleveland Clinic explains that a sustained heart rate below 60 when you’re not sleeping or resting may be a medical condition called bradycardia.
Bradycardia is a condition that increases with age. It’s most common in men and women over age 65, Cleveland Clinic says. Although healthy and fit young people and trained athletes can have heart rates down into the 40s without any symptoms, bradycardia may cause symptoms for other people. These can include:
The most common cause of symptomatic bradycardia is a problem that develops with the heart’s natural pacemaker, called the sinus node, Cleveland Clinic notes. There may also be a block of electrical signals between the upper and lower chambers of the heart, called an AV block. Another common cause is a heart or blood pressure medication that slows down the heart, it says.
“Symptoms of bradycardia may only be felt during activity. You could have a heart rate of 50 at rest without any symptoms, but if you get up and active, even a heart rate of 60 or 65 could be too slow and cause symptoms. If you have symptomatic bradycardia, you may need treatment,” Dr. Santucci says.
Mayo Clinic recommends letting your doctor know if you’re not a trained athlete and your resting heart rate is under 60. This is even more important if you have symptoms of bradycardia.
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