Slow Heartbeat and Discomfort: When to Seek Cardiology Care

Recently, I have been feeling discomfort in my heart, accompanied by a slower heartbeat?

Hello Doctor, I have hyperthyroidism (my levels are normal after medication and I have stopped taking it under the doctor's advice) and hypertension.
I am currently taking 80 mg of Amlodipine regularly every day, and I occasionally experience palpitations, for which I take 10 mg of Bisoprolol twice a day as needed.
My recent systolic blood pressure readings are between 145-115, and diastolic readings are between 95-77.
My heart rate usually ranges from 66 to 89.
Over the past week, I have noticeably felt discomfort in my heart at night, but it feels different from my previous palpitations.
At the time of discomfort, my blood pressure and heart rate readings were 115/76 at 52 bpm, 119/80 at 48 bpm, 126/87 at 59 bpm, 136/90 at 56 bpm, and 139/95 at 55 bpm.
I noticed that during these episodes of discomfort, my heart rate was slower than usual.
Should I seek a cardiology consultation promptly, or can I wait until my follow-up appointment with the endocrinologist in two months to discuss this with my doctor?

Yutou, 30~39 year old female. Ask Date: 2023/11/30

Dr. He Dongjin reply Cardiology

Hello, it is recommended to visit the cardiology outpatient clinic for further examination.
Pingan Changhua Hospital cares about you.

Reply Date: 2023/11/30

More Info

Based on your description, it seems you are experiencing episodes of discomfort associated with a slow heart rate, particularly at night. You have a history of hyperthyroidism, which has been managed, and hypertension for which you are on medication. Your blood pressure readings indicate some variability, and your heart rate has been on the lower side during these episodes of discomfort.

Understanding Your Symptoms
1. Heart Rate Variability: A heart rate of 66-89 beats per minute (bpm) is generally considered normal for adults at rest. However, if you are experiencing episodes where your heart rate drops significantly (e.g., below 60 bpm), especially if accompanied by discomfort, this could be concerning. A slow heart rate (bradycardia) can sometimes lead to inadequate blood flow to the organs, causing symptoms like dizziness, fatigue, or discomfort.

2. Blood Pressure Readings: Your blood pressure readings show some fluctuations, with systolic values ranging from 115 to 145 mmHg and diastolic values from 77 to 95 mmHg. While these values are not alarmingly high, the variability, especially in conjunction with a lower heart rate, warrants attention.

3. Symptoms of Discomfort: You mentioned that the discomfort feels different from your usual palpitations. This change in sensation is important to note, as it may indicate a different underlying issue. The fact that you are experiencing this discomfort primarily at night could suggest several possibilities, including anxiety, changes in autonomic nervous system activity, or even medication effects.

When to Seek Medical Attention
Given your symptoms and medical history, it is advisable to consult a cardiologist sooner rather than later. Here are some reasons why:
- New or Worsening Symptoms: Any new or changing symptoms, especially those involving the heart, should be evaluated promptly. The discomfort you are feeling, particularly if it is different from what you have experienced before, could indicate a need for further investigation.

- Bradycardia: If your heart rate is consistently dropping below 60 bpm and you are experiencing discomfort, this could be a sign of bradycardia that may require intervention.
- Medication Review: Since you are on multiple medications, including a beta-blocker (likely the "心康樂錠" you mentioned), it is essential to ensure that your medication regimen is appropriate for your current health status. Beta-blockers can lower heart rate, and if you are experiencing bradycardia, your doctor may need to adjust your dosage or consider alternative treatments.

- Monitoring and Testing: A cardiologist may recommend further testing, such as an electrocardiogram (ECG), Holter monitor, or echocardiogram, to assess your heart's rhythm and function more closely. These tests can help identify any underlying issues that may not be apparent from your current symptoms alone.

Conclusion
In summary, while it may be tempting to wait until your next appointment with your endocrinologist, the nature of your symptoms suggests that a visit to a cardiologist is warranted sooner. It is essential to address any new or worsening symptoms, especially those related to heart rhythm and rate. Early intervention can help prevent potential complications and ensure that your treatment plan is optimized for your current health status. Please prioritize your health and seek medical attention as soon as possible.

Similar Q&A

Understanding Heart Discomfort: When to Seek Further Cardiac Evaluation

First, I would like to thank the doctor for taking the time to respond despite their busy schedule. About two years ago, I began to frequently experience chest tightness and episodes of my heart suddenly racing. After seeking medical attention, I underwent an electrocardiogram (E...

Dr. He Dongjin reply Cardiology
Hello, this sounds like typical autonomic nervous system dysfunction. You may simply need to consult a psychiatrist for a medication adjustment, and there should be no need for another cardiac examination. Pingan Changhua Hospital cares about you.

Understanding Heart Issues: When to Seek Medical Attention

I previously experienced a period of high stress where I often had palpitations. Sometimes, I felt my heart rate slow down and become weaker. There was an instance where each heartbeat felt sharp and painful for over a minute. I also fainted once during intense exercise. Recently...

Dr. He Dongjin reply Cardiology
Hello, it sounds like you may be experiencing autonomic nervous system dysfunction, mitral valve prolapse, or arrhythmia. It is recommended to avoid stimulating amusement rides and engage in manageable exercises. If you continue to feel unwell, it is advisable to visit a cardiolo...

Understanding Heart Discomfort: When to Seek Cardiac Care

Hello, doctor; this issue has been bothering me for a long time, but it has become particularly severe recently. I often experience chest tightness, and my pulse is irregular—sometimes it is suddenly very fast, then it can be very slow or weak. I have generalized edema, and I bec...

Dr. Cai Yaozhou reply Internal Medicine
If you see a cardiologist and they order a cardiac ultrasound, and the results are normal, it is likely that emotional stress is a significant contributing factor.

Understanding Chest Pain and Discomfort: When to Seek Cardiac Care

After the summer vacation, I have been staying at home quite often. Besides buying daily necessities, I rarely go out and often sit in front of the computer desk. Recently, for the past two days, I have been experiencing intermittent sharp pain in the center of my chest. The pain...

Dr. Wu Xueming reply Cardiology
Due to your young age and lack of chronic diseases, your risk of developing heart disease is very low. However, if symptoms persist, it is still advisable to visit a cardiology department for further evaluation.