Low Heart Rate (Bradycardia)

Introduction

A low heart rate, also known as bradycardia, is a condition where the heart beats fewer than 60 times per minute. While it can be normal in athletes and healthy individuals, it may also indicate an underlying health concern.

Causes of Bradycardia

1. Physiological Causes

  • Athletic Heart Syndrome: Well-trained athletes often have lower resting heart rates due to efficient heart function.
  • Sleep: Heart rate naturally decreases during deep sleep.

2. Pathological Causes

  • Heart Conditions: Diseases like sick sinus syndrome, heart blocks, or previous heart attacks can slow down the heart.
  • Electrolyte Imbalance: Low potassium or calcium levels can affect heart function.
  • Hypothyroidism: An underactive thyroid can reduce heart rate.
  • Medications: Beta-blockers, calcium channel blockers, and some antiarrhythmics can lower heart rate.
  • Aging: The heart's electrical system naturally weakens with age.

Symptoms of Bradycardia

  • Dizziness or fainting
  • Fatigue or weakness
  • Shortness of breath
  • Chest discomfort
  • Confusion or memory problems

Diagnosis

A cardiologist may use: - Electrocardiogram (ECG/EKG) to measure electrical activity. - Holter monitoring for continuous recording. - Blood tests to check for imbalances. - Echocardiogram to assess heart function. - Electrophysiological testing in complex cases.

Treatment Options

The treatment depends on the cause: - No treatment needed for athletes or healthy individuals. - Medication adjustments if drugs are causing bradycardia. - Treatment of underlying conditions like hypothyroidism or electrolyte imbalances. - Pacemaker implant if the heart's electrical system is failing.

Prevention and When to Seek Help

  • Maintain a healthy lifestyle: balanced diet, exercise, and stress management.
  • Monitor medications that may slow heart rate.
  • Seek immediate medical attention if you experience severe symptoms like fainting or chest pain.

Conclusion

Bradycardia can be harmless or a serious condition requiring medical intervention. Regular check-ups and prompt attention to symptoms can help manage risks effectively.

Source recommendations

1. American Heart Association Guidelines on Bradycardia

  1. https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/bradycardia--slow-heart-rate
  2. https://cpr.heart.org/-/media/cpr-files/cpr-guidelines-files/algorithms/algorithmacls_bradycardia_200612.pdf
  3. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000628
  4. https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/algorithms
  5. https://pubmed.ncbi.nlm.nih.gov/30586772/

2. European Society of Cardiology Guidelines on Cardiac Arrhythmias

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Ventricular-Arrhythmias-and-the-Prevention-of-Sudden-Cardiac-Death
  2. https://academic.oup.com/eurheartj/article/43/40/3997/6675633
  3. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Supraventricular-Tachycardia
  4. https://pubmed.ncbi.nlm.nih.gov/36017572/
  5. https://www.ahajournals.org/doi/10.1161/01.cir.0000091380.04100.84

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