Understanding Low Pulse Rate (Bradycardia)

Introduction

A low pulse rate, medically known as bradycardia, is when the heart beats less than 60 beats per minute (bpm) in adults. While it can be normal for athletes and physically active people, it may also indicate an underlying heart condition in others.

Causes of Bradycardia

Physiological Causes (Normal Variants):

• Athletic heart syndrome – A well-trained heart pumps blood efficiently at a slower rate.
• During sleep – Heart rate naturally slows down when resting.

Pathological Causes (Potential Health Issues):

• Heart conduction problems – Dysfunction in the heart’s electrical system (e.g., sick sinus syndrome, heart block).
• Hypothyroidism – An underactive thyroid can slow the heart rate.
• Electrolyte imbalances – Low potassium or calcium can interfere with heart function.
• Certain medications – Beta-blockers, calcium channel blockers, and some sedatives can lower heart rate.
• Heart disease – Conditions like myocardial infarction (heart attack) or heart failure can lead to bradycardia.

Symptoms of Bradycardia

Not everyone with a low pulse experiences symptoms, but when the heart pumps too slowly, the following symptoms may occur: - Dizziness or lightheadedness - Fatigue or weakness - Shortness of breath - Fainting or near fainting (syncope) - Chest pain (if due to heart disease) - Confusion or memory problems (especially in older adults)

When to See a Doctor

Seek medical attention if you experience: - Consistently slow pulse (<50 bpm) with symptoms. - Episodes of fainting or dizziness. - Shortness of breath or chest pain.

Diagnosis

Doctors may use the following tests: - Electrocardiogram (ECG) – To measure the heart's electrical activity. - Holter monitor – 24- or 48-hour monitoring for irregularities. - Blood tests – To check for thyroid function, electrolytes, or infections. - Echocardiogram – To assess the heart’s structure and function.

Treatment Options

• Lifestyle modifications – Proper hydration, electrolyte balance, and avoiding excessive alcohol or drugs.
• Addressing underlying conditions – Treating hypothyroidism or adjusting medications.
• Pacemaker implantation – In severe cases of persistent bradycardia, a pacemaker may be required.

Conclusion

A low pulse rate can be normal in some individuals but may also signal an underlying issue. If you experience symptoms, it's important to visit a healthcare professional for an accurate diagnosis and treatment.

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 Bradycardia Management

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Cardiac-Pacing-and-Cardiac-Resynchronization-Therapy
2. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000628
3. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines
4. https://academic.oup.com/eurheartj/article/39/21/1883/4939241
5. https://pubmed.ncbi.nlm.nih.gov/15519256/