Slow Heart Rate: Causes, Symptoms, and Solutions

Bradycardia accompanied by occasional chest tightness and headaches?

Hello Doctor, four years ago I attended a gathering at a friend's house where I consumed alcohol.
That same night, I experienced severe arrhythmia and extreme discomfort that lasted for three days.
At that time, I did not seek medical attention and only rested at home.
Since then, my heart condition has occasionally caused discomfort, with symptoms evolving from occurring once every few days to now happening almost every two to three days.
Currently, I often feel chest tightness, and my right lung feels like it can't get enough air, with symptoms persisting for a long time.
My heart rate increases, followed by headaches that feel like blood is rushing to my head.
I cannot sit down; if I do, the headache worsens, and I can only feel somewhat better by walking slowly.
When I am not experiencing symptoms, my heart rate feels very slow.
Four years ago, my heart rate was around seventy beats per minute, but it dropped to the fifties last year and to the forties this year.
I previously sought treatment at a well-known hospital in Dajia, Taichung, where I initially experienced improvement with medication, but gradually it felt ineffective.
I kept informing the doctor, but they said everything was normal.
I then transferred to another well-known hospital in Shalu, Taichung, where I am still on medication.
I have been taking the medication regularly, but I don't feel any significant effects.
I have consistently reported to the doctor that my heart rate seems slow, and when measured with a blood pressure monitor, it only shows in the forties, but the doctor insists this is normal.
Each time my symptoms flare up, it is truly uncomfortable; I even struggle to speak without gasping for air, and the symptoms come on suddenly.
I cannot sit down to rest, as it makes me feel worse.
Doctor, I would like to ask how I should handle this situation.

Qiu Xiansheng, 60~69 year old female. Ask Date: 2017/02/10

Dr. He Dongjin reply Cardiology

Hello, I apologize for not having your electrocardiogram or other data, which prevents me from providing more accurate advice.
It is recommended that you visit the cardiology outpatient clinic at the hospital across from Donghai University on Dadu Mountain for further examination.
Changhua Hospital is concerned about your well-being.

Reply Date: 2017/02/10

More Info

Understanding a slow heart rate, or bradycardia, is crucial, especially when it is accompanied by symptoms such as chest discomfort, shortness of breath, and fatigue. Bradycardia is defined as a heart rate of fewer than 60 beats per minute (BPM) and can be a normal physiological response in well-trained athletes or during sleep. However, in non-athletic individuals, especially when accompanied by symptoms, it can indicate underlying health issues.

Causes of Bradycardia
Bradycardia can be caused by various factors, including:
1. Intrinsic Heart Conditions: Conditions affecting the heart's electrical system, such as sick sinus syndrome or atrioventricular (AV) block, can lead to a slow heart rate. Your 24-hour ECG report indicated a first-degree AV block, which can contribute to bradycardia.

2. Medications: Certain medications, particularly beta-blockers or calcium channel blockers, can slow the heart rate. If you are on any medications, it is essential to discuss their potential side effects with your doctor.

3. Electrolyte Imbalances: Imbalances in potassium or calcium levels can affect heart rhythm and rate.

4. Hypothyroidism: Although you mentioned that you do not have hypothyroidism, it is a common cause of bradycardia and should be ruled out if symptoms persist.

5. Age-Related Changes: As individuals age, the heart's electrical system may naturally slow down, leading to bradycardia.

Symptoms of Bradycardia
Symptoms can vary widely among individuals but may include:
- Fatigue or weakness
- Dizziness or lightheadedness
- Shortness of breath
- Chest pain or discomfort
- Confusion or memory issues
In your case, the symptoms of chest tightness, shortness of breath, and headaches are concerning and warrant further investigation. The fact that these symptoms have become more frequent and severe over time suggests that they should not be dismissed as normal, especially since they significantly affect your quality of life.

Solutions and Next Steps
1. Consult a Cardiologist: Given your symptoms and the history of heart rhythm issues, it is crucial to consult a cardiologist for a thorough evaluation. They may recommend additional tests, such as an echocardiogram, stress test, or even an electrophysiological study, to assess the heart's electrical activity and structure.

2. Medication Review: If you are on any medications, review them with your doctor to determine if they could be contributing to your symptoms. Adjustments may be necessary.

3. Lifestyle Modifications: While you are already active, consider incorporating more cardiovascular conditioning exercises, as tolerated, to improve overall heart health. However, ensure that any exercise regimen is approved by your healthcare provider.

4. Monitor Symptoms: Keep a detailed diary of your symptoms, including their frequency, duration, and any associated activities. This information can be invaluable for your healthcare provider in diagnosing and managing your condition.

5. Emergency Plan: Given the severity of your symptoms, especially if you experience significant chest pain or shortness of breath, have a plan in place for seeking immediate medical attention.

Conclusion
Bradycardia can be a benign condition in some individuals, but when accompanied by distressing symptoms, it requires careful evaluation and management. Your experience of worsening symptoms, particularly the episodes of chest discomfort and shortness of breath, should not be taken lightly. It is essential to advocate for your health and seek further evaluation to ensure that any underlying issues are addressed appropriately. Remember, your health and well-being are paramount, and persistent symptoms warrant thorough investigation and treatment.

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