Sudden Bradycardia: Causes and Solutions for Your Heart Rate

Sudden decrease in heart rate?

Hello, doctor.
I am 37 years old, with a blood pressure of 170/70.
I have a habit of smoking.
Over the past two years, due to excessive alcohol intake, approximately one bottle of red wine per day, I developed hypertension and sought medical attention.
After taking medication for a year, I stopped drinking, which caused my blood pressure to drop too low, so my doctor allowed me to discontinue the medication about two weeks ago.
My blood pressure has been relatively normal since then.
However, I am currently experiencing bradycardia, with my heart rate sometimes dropping to 55-60 beats per minute, accompanied by brief dizziness and difficulty breathing.
My heart rate has generally been on the higher side, around 78-90 beats per minute.
I also have an anxiety disorder and am undergoing treatment with SSRIs, so the sudden onset of bradycardia is puzzling to me.
Typically, alcohol withdrawal and anxiety attacks present with tachycardia, but now I am experiencing bradycardia instead.
I went to the hospital for an X-ray and an electrocardiogram, but the doctor found no abnormalities.
What should I do about this? Thank you.

Ted, 30~39 year old female. Ask Date: 2015/08/03

Dr. He Dongjin reply Cardiology

Hello, you can first visit the cardiology outpatient clinic for an examination, which showed no other abnormalities.
You may consider reducing the SSRI medication as a trial.
Changhua Hospital is concerned about you.

Reply Date: 2015/08/03

More Info

Understanding sudden bradycardia, especially in the context of your recent health changes, is crucial for managing your symptoms effectively. Bradycardia, defined as a heart rate of fewer than 60 beats per minute, can be caused by various factors, including lifestyle changes, medications, and underlying health conditions.

In your case, several key factors may be contributing to your bradycardia. First, you mentioned a history of high blood pressure and recent cessation of antihypertensive medication due to low blood pressure after quitting alcohol. Alcohol withdrawal can lead to various cardiovascular responses, including changes in heart rate. While many individuals experience tachycardia (increased heart rate) during withdrawal, others may experience bradycardia, especially if their body is adjusting to the absence of alcohol, which can have a depressant effect on the heart.

Your anxiety disorder and the use of SSRIs (selective serotonin reuptake inhibitors) can also play a role. SSRIs can affect heart rate and rhythm, and anxiety can lead to fluctuations in heart rate. It’s not uncommon for individuals with anxiety to experience both tachycardia and bradycardia, depending on their stress levels and physiological responses at any given time.

Given your symptoms of dizziness and shortness of breath accompanying the bradycardia, it is essential to monitor these closely. While your heart rate of 55-60 beats per minute may not be alarming in a resting state, the associated symptoms could indicate that your body is not tolerating this heart rate well.
Here are some steps you can take to address your situation:
1. Follow-Up with Your Healthcare Provider: Since you have already undergone X-rays and an ECG with no significant findings, it would be wise to schedule a follow-up appointment with your healthcare provider. They may consider additional tests, such as a 24-hour Holter monitor, to assess your heart rate variability throughout the day and identify any patterns or triggers for your bradycardia.

2. Lifestyle Modifications: Continue to focus on a healthy lifestyle. Since you have quit alcohol, maintaining this change is crucial. Additionally, consider reducing your caffeine intake, as it can sometimes exacerbate anxiety and affect heart rate. Regular, moderate exercise can also help improve cardiovascular health, but ensure that you consult with your doctor before starting any new exercise regimen, especially given your symptoms.

3. Monitor Your Symptoms: Keep a diary of your heart rate, symptoms, and any potential triggers (like stress or anxiety levels). This information can be valuable for your healthcare provider in determining the best course of action.

4. Manage Anxiety: Since you have a history of anxiety, it may be beneficial to continue your treatment and possibly explore additional therapeutic options, such as cognitive-behavioral therapy (CBT) or mindfulness techniques, which can help manage anxiety symptoms and potentially stabilize your heart rate.

5. Consider Medication Review: Discuss with your doctor the possibility of reviewing your current medications, including the SSRIs. Sometimes, adjustments in dosage or switching to a different medication can alleviate side effects that may be contributing to bradycardia.

In summary, while bradycardia can be concerning, especially with accompanying symptoms, it is essential to approach this situation holistically. Regular follow-ups with your healthcare provider, lifestyle modifications, and effective management of anxiety can significantly improve your overall well-being and heart health. If your symptoms worsen or you experience significant changes, seek medical attention promptly.

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