When To Worry About A Low Heart Rate
When a drop in your heart rate is natural and harmless, it doesnt cause any symptoms. But if you also have one of the following symptoms, it could be a sign that something else is going on:
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Dizziness or lightheadedness
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Palpitations or a sensation of skipped heartbeats
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A new difficulty in your ability to exercise or exert yourself
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Excessive fatigue
But more concerning bradycardia doesnt always cause symptoms. Even if you dont have any symptoms, its a good idea to talk to your healthcare provider if you have new bradycardia and one of the following conditions:
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Age over 50 years old
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A history of electrolyte abnormalities
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Thyroid problems
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A heart rate below 40 beats per minute
There are some simple and easy tests that your provider can do to figure out if your heart rate is a problem. These can include an electrocardiogram and echocardiogram , or blood tests if your provider suspects a thyroid or electrolyte problem. Your provider may also recommend you wear a small heart monitor for a few days, which can monitor your heart beat 24/7.
Types Of Heart Medications
If you’ve had a heart attack, you will most likely be prescribed medication that you will take for the rest of your life.
There are many types and combinations of drugs used to treat coronary artery disease , and your doctor or other health care provider will decide the best treatment combination for your situation.
The following gives you a quick look at many typical cardiac medications. Your prescription may have a different name from the ones listed on this chart. Brand names commonly available in the U.S. are shown in parentheses after the generic name for each drug.
*Some of the major types of commonly prescribed cardiovascular medications are summarized in this section. For your information and reference, we have included generic names as well as major trade names to help you identify what you may be taking. However, the AHA is not recommending or endorsing any specific products. If your prescription medication isn’t on this list, remember that your healthcare provider and pharmacist are your best sources of information. It’s important to discuss all of the drugs you take with your provider and understand their desired effects and possible side effects. Never stop taking a medication and never change your dose or frequency without first consulting the prescribing doctor.
Commonly prescribed include:
What the Medication Does
Reason for Medication
Low Rates In Active Bodies
People who are very active, including athletes, tend to have naturally lower resting pulse rates –even lower than 60. This is a reflection of a strong, efficient heart muscle that doesn’t need to work as hard to do its job in maintaining a steady beat. So a low heart rate, in an absence of symptoms, doesn’t necessarily signal a dangerous condition.
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Keys To Getting An Accurate Result
Resting heart rate is determined with a pulse measurement when you are relaxed and at rest. Do not take resting heart rate after:
- Active exercise
Some common causes of low heart rates include the following:
- Heart medications like beta-blockers, certain calcium channel blockers, and even some eye drops
What Is A Pacemaker
A small battery-operated device that helps the heart beat in a regular rhythm. There are two parts: a generator and wires .
- The generator is a small battery-powered unit.
- It produces the electrical impulses that stimulate your heart to beat.
- The generator may be implanted under your skin through a small incision.
- The generator is connected to your heart through tiny wires that are implanted at the same time.
- The impulses flow through these leads to your heart and are timed to flow at regular intervals just as impulses from your heart’s natural pacemaker would.
- Some pacemakers are external and temporary, not surgically implanted.
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Causes Of A Slow Heart Rate
Its normal for your heart rate to change throughout the day. It speeds up when you exercise, slows down as you recover from exercising, and is usually at its lowest while you sleep.
Sometimes people have a slower heart rate than normal. This is called bradycardia, and it isnt necessarily a problem. Its diagnosed when your heart beats less than 60 beats per minute.
There are several causes of a slow heart rate. The most common are being young or physically fit. The heart is a muscle, and just like the other muscles in your body, it responds positively to exercise. When youre in good shape, your heart doesnt need to beat as often to supply your body with enough oxygen.
But a slow heart rate can also be a sign of a medical problem, such as a heart condition. If your resting heart rate is slow and you have other symptoms of bradycardia such as lightheadedness, call your doctor or go to the ER.
How Are Arrhythmias Treated
Many arrhythmias dont need treatment. For those that do, these options might be used:
- Medicines. Many types of prescription anti-arrhythmic medicines are available to treat arrhythmia. Sometimes, these can increase symptoms and cause side effects, so the patient will be closely watched by the doctor.
- Pacemakers. A pacemaker is a small battery-operated device implanted into the body through a surgical procedure. Connected to the heart by a wire, a pacemaker can detect if the heart rate is too slow and send electrical signals to speed up the heartbeat.
- Defibrillators. A small battery-operated implantable cardioverter defibrillator is surgically placed near the left collarbone. Wires run from the defibrillator to the heart. The ICD senses if the heart has a dangerously fast or irregular rhythm and sends an electrical signal to restore a normal heartbeat.
- Catheter ablation. A catheter is guided through a vein in the leg to the heart. Arrhythmias often are caused by microscopic defects in the heart muscle. Once the problem area of the heart is pinpointed, the catheter heats or freezes the defective muscle cells and destroys them.
- Surgery. Surgery is usually the treatment recommended only if all other options have failed. In this case, a person is put under anesthesia and a surgeon removes the tissue causing the arrhythmia.
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Antiplatelet Agents And Dual Antiplatelet Therapy
Commonly prescribed include:
Keeps blood clots from forming by preventing blood platelets from sticking together.
Reason for Medication
- Helps prevent clotting in patients who have had a heart attack, unstable angina, ischemic strokes, TIA and other forms of cardiovascular disease.
- Can also be prescribed preventively when plaque buildup is evident but there is not yet a major blockage in the artery.
- Certain patients will be prescribed aspirin combined with another antiplatelet drug also known as dual antiplatelet therapy .
Dual Antiplatelet Therapy
Some patients who have heart attacks, that have stents placed in their coronary arteries, or undergo coronary artery bypass graft surgery are treated with two types of antiplatelet agents at the same time to prevent blood clotting. This is called dual antiplatelet therapy .
One antiplatelet agent is aspirin. Almost everyone with coronary artery disease, including those who have had a heart attack, stent, or CABG are treated with aspirin for the rest of their lives. A second type of antiplatelet agent, called a P2Y12 inhibitor, is usually prescribed for months or years in addition to the aspirin therapy.
The type of medication and the duration of your treatment will vary based on your condition and other risk factors. The risks and benefits of DAPT should be discussed with your health care provider.
- Cholesterol absorption inhibitor: Ezetimibe
- Combination statin and cholesterol absorption inhibitors: Ezetimibe/Simvastatin
How To Improve Your Resting Heart Rate
You can lower your resting heart rate by improving your physical fitness and making some lifestyle changes.
Regular cardio exercise, like running, swimming, or biking, trains the heart to be more efficient over time. With each heartbeat, the “athletic heart” maintains its output of blood to the body at a lower heart rate.
In addition to exercise, other actions that may improve your resting heart rate include:
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Checking In On Your Device
Modern pacemakers are built to last. Still, your pacemaker should be checked periodically to assess the battery and find out how the wires are working. Be sure to keep your pacemaker checkup appointments. At such appointments:
- Your doctor will make sure your medications are working and that youre taking them properly.
- You can ask questions and voice any concerns you may have about living with your pacemaker. Make sure you and your caregiver understand what your doctor says. Its a good idea to take notes.
- Your doctor will use a special analyzer to reveal the batterys strength. This diagnostic tool can reveal a weak battery before you notice any changes.
Eventually, the battery may need to be replaced in a surgical procedure. This replacement procedure is less involved than the original surgery to implant the pacemaker. Your doctor can tell you about the procedure when the time comes.
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About Heart And Vascular Institute
The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine. We strive to provide the most advanced, cutting-edge care for our patients, treating both common and complex conditions. We also offer services that seek to improve the health of our communities, including heart screenings, free clinics, and heart health education. Find an expert near you.
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Know Your Numbers: Heart Rate
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The better you understand your heart rate, the more you can maximize your movement to give your heart a good workout.
What is your heart rate?
Your heart rate, or pulse, is the number of times your heart beats per minute. Your resting heart rate is the heart pumping the lowest amount of blood you need because you’re not exercising. If you are sitting or lying down and you’re calm, relaxed and aren’t ill your heart rate is normally between 60 and 100 beats per minute.
Other factors can affect your heart rate include:
- Air temperature When temperatures or humidity increases, the heart pumps more blood so you pulse or heart rate may increase.
- Body position Sometimes when going from a sitting to a standing position, your pulse may go up a little. After a few minutes, it should return to a normal rate.
- Medications that block adrenaline tend to slow your heart rate. Thyroid medication may raise it.
Why your heart rate matters
Learn why you should track physical activity.
What’s considered normal?
Your target heart rate is the minimum heart rate in a given amount of time to reach the level of energy necessary to give your heart a good workout. To find your target heart rate to maximize your cardiovascular exercise, the first step is determining your maximum heart rate.
Your maximum heart rate is 220 minus your age. Your target heart rate for moderate exercise is about 50%85% of your maximum heart rate.
Averages by age as a general guide are:
A Low Heart Rate Can Lead To Fainting And Falls If Youre Not A Highly Trained Athlete But The Condition Is Often Treatable
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Health risks can develop from a low heart ratea condition called bradycardia.
A low heart rate may be a sign of an efficiently working heart. Or, if the rate becomes too low, it could be a sign of health complications down the road.
A normal or healthy resting heart rate for an adult is between 60 and 100 beats a minute. A heart rate near the lower end of that range is considered a good sign. Your heart isnt working too hard to pump blood effectively throughout the body. Its one indication of cardiovascular fitness. A very rapid heart rate, on the other hand, raises your risk of heart failure, blood clots, and other problems.
If youre not training for a marathon or swimming dozens of laps every day, you should talk with your doctor if you notice a low heart rate.
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Check Your Resting Heart Rate Early And Often
Dr. Wasfy recommends checking your resting heart rate a few times per week and at different times of the day. Keep in mind that the number can be influenced by many factors, including stress and anxiety, circulating hormones, and medications such as certain antidepressants and some blood pressure drugs.
Talk with your doctor if your resting heart rate is regularly on the high end. There are ways to lower it and keep it within its proper range. One example is keeping your cholesterol levels in check. High levels restrict blood flow through the arteries and damage blood vessels, which can make your heart beat faster than normal to move blood through the body.
Another reliable way to lower your resting heart rate is to exercise. “Even small amounts of exercise can make a change,” says Dr. Wasfy. However, the intensity of the exercise is key. One study that involved 55-year-old adults found that just one hour per week of high-intensity aerobic training lowered RHR more efficiently than a low-intensity effort .
Tips for measuring your resting heart rate
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What Other Conditions Cause A Low Heart Rate
Many of the medical conditions that cause bradycardia are more common in people who are older or have underlying heart conditions. Some examples of medical problems that can cause bradycardia include:
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Problems with the hearts electrical pathways: There is a special electrical circuit in our heart that controls each heart beat. Problems with this conduction system can cause the signal to go awry. This is called an arrhythmia.
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An abnormal shape or structure of the heart: The shape and size of the heart can begin to change in response to other medical problems. Examples include high blood pressure, coronary artery disease, or heavy alcohol use. Some people are born with certain defects, too. All of these conditions can affect the conduction system we just mentioned.
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Metabolic abnormalities: The heart requires the right balance of electrolytes and hormones to pump correctly. Conditions like hypothyroidism or low potassium levels can cause the heart to beat too slowly.
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New Findings Focus On Diastolic Blood Pressurethe Second Number In Your Blood Pressure Reading
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Of the two numbers that make up your blood pressure reading, the first one typically gets more attention. Thats because as people age, their arteries lose their elasticity, and the inner walls are more likely to accumulate cholesterol-laden plaque. These factors tend to raise systolic blood pressure, a measure of the pressure inside the arteries when the heart contracts to pump blood throughout the body.
Current guidelines suggest that most people should aim for a systolic blood pressure reading of 140 millimeters of mercury or lower. But last year, a widely publicized clinical trial suggested that a target of 120 mm Hg could further reduce the dangers associated with high blood pressure .
Yet reaching that lower target required an average of three blood pressure medications, which resulted in more side effects. Now, two recent observational studies highlight some concerns about blood pressure thats too low, particularly with regard to diastolic blood pressure. Diastolic blood pressure represents the pressure between beats when the heart relaxes.
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Whats A Normal Heart Rate
Most adults have a resting heart rate that falls within the range of 60 to 100 beats per minute.
However, your heart rate may rise much higher than that when you exert yourself while exercising or if your heart races when you feel stressed. Additionally, your heart rate may fall lower than the typical range while youre sleeping, particularly if youre a healthy young adult or an elite athlete.
Doctors consider a resting heartbeat thats higher than 100 beats per minute to be higher than normal and a resting heart rate thats lower than 60 beats per minute to be lower than normal.
Its healthier to have a resting heart rate thats toward the lower end of the 60- to 100-beat range, although this varies by person, says interventional cardiology specialist, David Landers, M.D.When your resting heart rate is lower, it typically means that the heart is working efficiently, and its associated with healthy attributes like healthy blood-pressure levels and a healthy body weight.
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Measuring Your Heart Rate
Checking your resting heart rate isnt difficult. Start by sitting quietly for five minutes or so. Then, place two fingers on the thumb side of your wrist, between the bone and the tendon over your radial artery. Once you feel a pulse, count the number of beats for 15 seconds. Then multiply that number by four. That will give you your beats per minute.
Its a good idea to do this every so often, just to have a baseline number. If you notice a changeup or downtell your doctor at your next appointment. You should also talk with your doctor about your target heart rate, particularly if you are an older adult or you have risk factor for cardiovascular problems, such as diabetes, family history of heart disease, smoking, obesity, a sedentary lifestyle, or high blood pressure.
Keep in mind that your heart rate should go up when you exercise and then return to a normal resting heart rate soon after you stop. If your heart rate doesnt rise very much or takes a long time to return to normal, tell your doctor. It may be a sign of a heart that isnt working optimally. It may not be serious, but it is worth a discussion with your physician.
This article was originally published in 2018. It is regularly updated.