Heart Palpitations and Low Heart Rate: When to Seek Help

Skipped heartbeats and bradycardia?

Hello Doctor: Since last year, I have been experiencing irregular heartbeats almost every day, both during the day and at night.
When I check my pulse, I often notice skipped beats.
Previously, I measured my blood pressure and found it to be on the low side.
When using my phone to measure my heart rate, it frequently fluctuates between 40 and 60 beats per minute.
Aside from noticeable palpitations and occasional mild chest pain that isn't very severe, I don't have other symptoms such as shortness of breath or fainting.
My daily life has not been significantly affected.
I would like to ask if this situation means that there is no need for a medical examination, since I seem to be functioning well overall?

aaa, 20~29 year old female. Ask Date: 2023/03/27

Dr. He Dongjin reply Cardiology

Hello, if you are feeling well, there is no need to seek medical examination; it is sufficient to observe your condition.
Changhua Hospital cares about you.

Reply Date: 2023/03/27

More Info

Heart palpitations and low heart rates can be concerning symptoms, and it's important to understand when to seek medical attention. Based on your description, you have been experiencing daily heart palpitations, a low heart rate (40-60 beats per minute), and occasional mild chest pain, but you do not have other symptoms like shortness of breath or fainting. While it may seem that you are managing well, there are several factors to consider regarding your heart health.

Understanding Heart Palpitations
Heart palpitations are sensations that your heart is beating too hard, too fast, or irregularly. They can be caused by a variety of factors, including stress, anxiety, caffeine intake, hormonal changes, or underlying medical conditions. In your case, the fact that you are experiencing these palpitations daily suggests that it may be worth investigating further, especially since you have noted a low heart rate.

Low Heart Rate (Bradycardia)
A resting heart rate below 60 beats per minute is classified as bradycardia. While some individuals, especially athletes, may have a naturally low heart rate without any adverse effects, it can also indicate an underlying issue, particularly if accompanied by symptoms like palpitations or chest pain. Bradycardia can result from various factors, including:
1. Heart Block: A condition where the electrical signals in the heart are delayed or blocked.

2. Medications: Certain medications, especially beta-blockers or other heart medications, can lower heart rate.

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

4. Hypothyroidism: An underactive thyroid can lead to a slower heart rate.

5. Aging: The natural aging process can affect the heart's electrical system.

When to Seek Help
Even if you feel that your daily life is not significantly impacted, it is essential to consult a healthcare professional if you experience any of the following:
- Worsening Symptoms: If your palpitations become more frequent or severe, or if you start experiencing new symptoms such as dizziness, fainting, or severe chest pain.

- Persistent Low Heart Rate: A consistently low heart rate, especially if it drops below 40 beats per minute, warrants medical evaluation.

- Family History: If there is a family history of heart disease or arrhythmias, it is advisable to seek a professional opinion.

- Lifestyle Changes: If you notice changes in your ability to perform daily activities or if you feel more fatigued than usual.

Diagnostic Tests
If you decide to seek medical help, your doctor may recommend several tests to evaluate your heart health, including:
- Electrocardiogram (ECG): To assess the heart's electrical activity and identify any irregularities.

- Holter Monitor: A 24-hour ECG to capture heart rhythms over an extended period.

- Echocardiogram: An ultrasound of the heart to evaluate its structure and function.

- Blood Tests: To check for thyroid function, electrolyte levels, and other potential underlying issues.

Conclusion
While it may seem that you are managing well, the combination of daily palpitations and a low heart rate should not be ignored. It is advisable to consult a healthcare professional for a thorough evaluation. Early detection and management of potential heart conditions can lead to better outcomes and peace of mind. Remember, it is always better to err on the side of caution when it comes to heart health.

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