Slow Heart Rate: When to Consult a Cardiologist

Bradycardia?

Hello, doctor.
I am the person who asked question #131133 and would like to continue consulting you about some issues.
My height and weight are 169 cm and 53 kg.
I have mild thalassemia and have been diagnosed with mild anxiety disorder.
I tend to excessively monitor my heart condition.
Previously, when lying flat before sleep, I measured my pulse and found my heart rate to be around 42 beats per minute.
During a 24-hour Holter monitor test, the report indicated that my lowest heart rate was 41 beats per minute, which occurred just before I woke up in the morning.
Recently, due to my anxiety disorder, I have started taking Seroxat (paroxetine) to manage it (I began taking it three days ago at a dosage of 12.5 mg, half a tablet per day).
In the evenings, I sometimes measure my heart rate, which is also around 50 beats per minute.
However, my blood pressure is normal, approximately 110/60 mmHg.
During the day, my heart rate often drops below 60, sometimes even around 50.
When I notice my heart rate is very slow, I feel a bit worried.
Initially, I was concerned that my heart rate would slow down even more, and occasionally I feel a missed beat when it is slow.
However, everything else seems normal, and I do not have any other significant symptoms.
Should I consult a cardiologist about this? My family members typically have heart rates around 70 beats per minute, and I am unsure why mine is so slow.
I also do not exercise regularly.
Thank you, doctor.

Xiao Zhang, 10~19 year old female. Ask Date: 2017/12/10

Dr. He Dongjin reply Cardiology

Hello, if your heart rate is below 60, even as low as 50, it may cause you some concern, especially when others have a heart rate around 70.
However, the actual heart rate is not a problem as long as you do not feel unwell.
It is sufficient to monitor your condition without any need for treatment or a visit to a cardiologist.
Peace of mind from Changhua Hospital cares for you.

Reply Date: 2017/12/10

More Info

When it comes to understanding a slow heart rate, or bradycardia, it's essential to consider various factors, including individual health conditions, lifestyle, and the presence of symptoms. A resting heart rate below 60 beats per minute is classified as bradycardia, and while it can be normal for some individuals, especially athletes or those who are physically fit, it can also indicate underlying health issues in others.

In your case, you mentioned experiencing a resting heart rate as low as 41 beats per minute, particularly when lying down before sleep. This is significantly lower than the average resting heart rate of 60-100 beats per minute for most adults. While some people naturally have lower heart rates, it is crucial to assess whether this is a benign condition or a sign of a more serious issue, especially given your history of mild anxiety and Mediterranean anemia.

The fact that you are experiencing a heart rate in the 40s and occasionally feeling like your heart skips a beat could be concerning. Bradycardia can lead to insufficient blood flow to the organs, which may cause symptoms such as fatigue, dizziness, or fainting. However, you indicated that you do not have significant symptoms apart from occasional anxiety about your heart rate, which is a common concern among individuals with anxiety disorders.

Given your situation, it is advisable to consult a cardiologist for a thorough evaluation. A cardiologist can perform additional tests, such as an echocardiogram or a stress test, to assess the function of your heart and determine if there are any underlying issues contributing to your bradycardia. They may also review your medication, particularly the Seroxat (paroxetine) you recently started, as some medications can influence heart rate.

Moreover, it is essential to monitor your heart rate and any associated symptoms. If you experience dizziness, fainting, or significant fatigue, these could be signs that your heart rate is too low and may require medical intervention. The cardiologist can help determine whether you need further treatment, such as a pacemaker, which is a device that helps regulate heartbeats in cases of severe bradycardia.

In summary, while a slow heart rate can be normal for some individuals, your specific circumstances warrant a professional evaluation. Consulting a cardiologist will provide you with peace of mind and ensure that any potential health issues are addressed appropriately. Remember, it is always better to err on the side of caution when it comes to heart health, especially if you have concerns or experience any symptoms.

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