I Have Been Experiencing A Heart Rate Dropping Into The

Posted on Tue, 7 Jul 2020

Question: I have been experiencing a heart rate dropping into the 40s in my sleep and in the 50s during the day. I’ve been experiencing a lot of headaches and migraines. I’ve noted when my heart rate is low I get chest pain, dizziness, fatigue and sometimes shortness of breath. Sometimes i tire out easily going up hills or stairs and get out of breath quickly. I exercise 4 times a week and sometimes get dizzy when I workout, I don’t drink alcohol or smoke. I eat a healthy diet and limit processed foods. What could be going on?

Answered by Dr. Aaron Branch (55 minutes later)

Brief Answer:
Many causes

Detailed Answer:
Hello, I'm Dr. Branch, thanks for using 'Ask a Doctor'. The causes of a low heart rate, or bradycardia, are many. Well-conditioned athletes can have a low heart rate, as well as older patients who have damage to their heart pacemaker. Also, medications, heart damage from a heart attack (which may or may not have symptoms), obstructive sleep apnea, some tick diseases, and hypothyroidism can contribute to a low heart rate.

Since it sounds like you are having symptoms when your heart rate gets low, it would be important that you be evaluated, first to get an EKG and see what kind of rhythm you have, and then to investigate for the cause. If no easily treated cause can be found, ultimately you may need a pacemaker.

I hope that helps, please let me know if you have any other questions about that, and I would be glad to discuss it with you further.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Aaron Branch (1 hour later)

Is there a heart monitor that does a 24 hour recorded so it can catch those lows? Or even something I’d wear for a week?
I wear an Apple Watch and have all the recordings on there but as far as the medical field goes, I don’t know how much they would rely on that.

I have been told I have a normal sinus rhythm with sinus arrhythmia but I’ve read that can be quite normal. But that was a few years ago.

What criteria do you have to meet in order for them to ultimately decide to put a pacemaker in?

Answered by Dr. Aaron Branch (53 minutes later)

Brief Answer:
A heart monitor would be considered

Detailed Answer:
Yes, a heart monitor would be considered if it wasn't clear if your symptoms were related to the slow heart rate or not, while an Apple Watch might help suggest that they are related, they would likely want to confirm with a heart monitor.

Basically, if there is no fixable cause for the slow heart rate, and you continue to have symptoms from it, that would be the indication for a pacemaker.

Please let me know if you have any other questions, I'd be glad to help any way I can.

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Kampana