Heart Rate Issues: When to Seek Immediate Medical Attention

Heart rate issues

Hello, Doctor.
A few years ago, I underwent catheter-based medication treatment for cardiac spasms and have been taking autonomic nervous system medications long-term.
I use a ventilator at night due to sleep apnea and also take cardiology medications including Eplerenone and Digoxin.
Additionally, I have recently forgotten to take the medication prescribed for blood circulation.
Over the past few months, I have been experiencing intermittent fatigue before bed and in the early morning, along with soreness in my left shoulder and left chest, which has been particularly noticeable in the past week.
This morning, I woke up with a blood pressure of 128/77, oxygen saturation of 98%, and a heart rate of 44.
For the first time, I felt my heart flutter upon waking.
During the day, I usually function normally, but these symptoms have persisted for some time.
I would like to know if these symptoms should not be ignored and under what circumstances I should seek immediate medical attention.
Thank you.

Li, 50~59 year old female. Ask Date: 2023/12/22

Dr. He Dongjin reply Cardiology

Hello, this symptom does not seem to indicate a heart problem and should be monitored.
For heart spasms and chest pain, sublingual tablets should be administered first, followed by observation.
Changhua Hospital cares about you.

Reply Date: 2023/12/22

More Info

When it comes to understanding heart rate issues and determining when to seek immediate medical attention, it's essential to consider a variety of factors, especially given your medical history and current symptoms. Based on your description, it appears that you have a complex medical background, including a history of heart spasms, the use of autonomic nervous system medications, and sleep apnea requiring a CPAP machine. Additionally, you mentioned experiencing fatigue, left shoulder and chest discomfort, and a notably low heart rate of 44 beats per minute upon waking, along with a recent episode of heart palpitations.

Key Considerations for Seeking Medical Attention
1. Heart Rate Concerns: A resting heart rate of 44 bpm is considered bradycardia (slow heart rate), which can be concerning, especially if you are symptomatic. Normal resting heart rates typically range from 60 to 100 bpm. Bradycardia can lead to insufficient blood flow to the organs, causing symptoms such as fatigue, dizziness, or fainting. If you experience persistent bradycardia, especially with symptoms like chest pain or shortness of breath, it is crucial to seek medical attention.

2. Chest Pain and Discomfort: You mentioned experiencing left chest and shoulder pain, which can be indicative of cardiac issues, especially in someone with your medical history. While not all chest pain is heart-related, it should never be ignored, particularly if it is new, persistent, or worsening. If you experience significant chest pain, especially if it radiates to the arm, neck, or jaw, or is associated with sweating, nausea, or shortness of breath, you should seek emergency medical care immediately.

3. Fatigue and Weakness: Feeling unusually fatigued, especially if it is a new symptom, can be a sign of underlying heart problems or other systemic issues. Given your history of heart conditions, it is essential to discuss these symptoms with your healthcare provider, as they may warrant further investigation.

4. Palpitations: The sensation of your heart "trembling" or palpitating can be a sign of arrhythmias. While occasional palpitations can be benign, if they are frequent, prolonged, or associated with other concerning symptoms (like those mentioned above), it is advisable to seek medical evaluation.

5. Medication Compliance: You mentioned forgetting to take your anticoagulant medication. Non-compliance with prescribed medications, especially those related to heart health, can have significant consequences. It is vital to maintain a consistent medication regimen and consult your healthcare provider if you have missed doses or are experiencing side effects.

When to Seek Immediate Medical Attention
- Severe Chest Pain: If you experience severe or persistent chest pain, especially if it feels like pressure or squeezing.

- Shortness of Breath: If you have difficulty breathing or feel like you cannot catch your breath.

- Dizziness or Fainting: If you feel lightheaded, dizzy, or faint, particularly if it occurs with a low heart rate.

- Rapid or Irregular Heartbeat: If you experience a sudden increase in heart rate or irregular heartbeats, especially if accompanied by other symptoms.

- New or Worsening Symptoms: Any new symptoms or a significant change in your existing symptoms should prompt a visit to your healthcare provider.

Conclusion
Given your complex medical history and the symptoms you are currently experiencing, it is essential not to ignore these signs. While some symptoms may seem mild or transient, they can indicate more serious underlying issues, especially in someone with a history of heart problems. It is always better to err on the side of caution. If you are ever in doubt about your symptoms or feel that something is not right, do not hesitate to seek medical attention. Regular follow-ups with your healthcare provider are crucial to managing your condition effectively and ensuring your heart health is monitored appropriately.

Similar Q&A

Understanding Irregular Heartbeats: When to Seek Medical Attention

During elementary school, I often experienced dizziness. Recently, I've felt my heart suddenly beating irregularly, but it resolves within a few seconds. The timing of these episodes is unpredictable, and they occurred more frequently last semester. Occasionally, I suddenly ...

Dr. He Dongjin reply Cardiology
Hello, you likely have mitral valve prolapse and some benign arrhythmias, which should be monitored without concern. Changhua Hospital cares about you.

Understanding Rapid Heartbeat: When to Seek Cardiac Evaluation

Hello doctor, I would like to inquire about my condition. For the past few days, whenever I stand, my heart rate exceeds 120 beats per minute. I have previously consulted a cardiologist and underwent an electrocardiogram (ECG) and echocardiogram, both of which showed no significa...

Dr. Wu Xueming reply Cardiology
Many factors in daily life can contribute to this condition, such as emotions, stress, irregular sleep patterns, or excessive consumption of caffeinated beverages. It is recommended to adjust your daily routine and engage in regular exercise. However, if symptoms persist, it is a...

Understanding Fast Heart Rate: When to Seek Medical Attention

Hello: Sometimes when I rest, my heart rate is quite fast (around 110 bpm or higher), but aside from feeling it beating quickly (not sure if that counts as palpitations), I don't have any other uncomfortable symptoms. If I'm not feeling unwell, what heart rate threshold...

Dr. He Dongjin reply Cardiology
Hello, everyone's resting heart rate is different. As long as you don't feel unwell, just observe it; there's no need to seek medical attention. For example, your heart rate is 110, while your father's is between 50 and 60. Just like height varies from person ...

Rapid Heartbeat After Chest Trauma: When to Seek Medical Attention?

Two weeks ago, I was hit in the chest. Although it feels a bit better now, I am experiencing some abdominal pain. I went to a small clinic, and they said my heart rate is over 120 beats per minute and that I should go to the hospital for further evaluation. They mentioned it coul...

Dr. Wu Xueming reply Cardiology
A heart rate exceeding 100 beats per minute is referred to as "sinus tachycardia," which is mostly benign. Factors such as stress, tea, alcohol, smoking, coffee, hyperthyroidism, or heightened sympathetic or parasympathetic nervous system activity can cause irregular he...