Bradycardia

Bradycardia: A Slow Heartbeat

A normal heart beats at a steady rhythm, sending blood throughout your body. The image on the left shows a healthy heart rhythm. The image on the right shows bradycardia, a condition where the heart beats too slowly.

Bradycardia is a slow heart rate. Usually, a resting adult heart beats between 60 and 100 times per minute. If you have bradycardia, your heart beats fewer than 60 times a minute. This slower pace can be a problem.

A heart that beats too slowly might not pump enough oxygen-rich blood to all parts of your body. If this happens, you might feel lightheaded, very tired, weak, or short of breath. Sometimes, bradycardia doesn't cause any noticeable symptoms.

It's important to understand that a slow heart rate isn't always bad. For example, a resting heart rate between 40 and 60 beats per minute is common in some healthy people, especially young adults and people who exercise regularly. It's also common when you're sleeping.

If bradycardia is severe, meaning the heart rate is dangerously slow, a device called a pacemaker might be necessary. A pacemaker sends electrical signals to the heart, helping it beat at a healthy rhythm.

A slow heartbeat, called bradycardia, can be a problem if it's too slow to properly supply the brain and other organs with oxygen. When this happens, you might notice several symptoms. These include:

• Chest pain: A feeling of discomfort or pressure in your chest.
• Confusion or trouble remembering things: Feeling foggy-headed or having difficulty concentrating.
• Dizziness or lightheadedness: Feeling unsteady or like you might pass out.
• Extreme tiredness, especially with activity: Feeling unusually fatigued, even after short periods of movement.
• Fainting or near-fainting: Losing consciousness or feeling very close to losing consciousness.
• Shortness of breath: Having difficulty breathing or feeling like you can't get enough air.

Many different things can cause a slow heartbeat and related symptoms. It's crucial to get a quick and accurate diagnosis from a doctor if you think you might have bradycardia. If you're concerned about your heart rate, schedule an appointment with your healthcare provider.

If you experience fainting, trouble breathing, or chest pain that lasts for more than a few minutes, immediately call 911 or your local emergency services. These are serious symptoms that require immediate medical attention.

A slow heart rate, or bradycardia, can have various causes. It's crucial to get a quick and correct diagnosis and the right treatment. If you're concerned about your heart rate being too slow, schedule a doctor's appointment.

If you experience sudden fainting, trouble breathing, or chest pain lasting more than a few minutes, immediately call 911 or your local emergency services. These are serious symptoms that need immediate medical attention.

The heart's normal rhythm starts with a small group of cells in the sinus node. This node sends an electrical signal that travels through the top two chambers of the heart (the atria) to a second node, the AV node. From there, the signal moves to the bottom two chambers (ventricles), making them squeeze and pump blood out.

Slow heartbeats (bradycardia) can happen for many reasons:

• Aging: As we get older, the heart's tissues can wear out, potentially affecting the heart's electrical signals.
• Heart disease and heart attack: Damage to heart tissue from these conditions can disrupt the heart's electrical system.
• Congenital heart defects: Some people are born with problems in their heart's structure or electrical pathways.
• Inflammation (myocarditis): Inflammation of the heart muscle can interfere with its electrical signals.
• Heart surgery complications: Sometimes, surgery can lead to problems with the heart's rhythm.
• Underactive thyroid (hypothyroidism): A sluggish thyroid gland can affect the heart's electrical signals.
• Mineral imbalances: Changes in the levels of minerals like potassium and calcium can impact the heart's ability to create and conduct electrical signals.
• Sleep apnea: This sleep disorder can disrupt heart rhythms.
• Inflammatory diseases (like rheumatic fever or lupus): These conditions can cause inflammation that affects the heart.
• Certain medicines: Some medications, including sedatives, pain relievers (opioids), and some heart or mental health drugs, can slow the heart rate.

Understanding why the heart beats slowly requires knowing its basic structure. The heart has four chambers: two upper chambers (the atria) and two lower chambers (the ventricles). The sinus node, located in the heart's upper right chamber, acts like the heart's natural pacemaker. It creates the electrical signals that tell the heart when to beat. In bradycardia, these signals are too slow or get blocked.

Several factors can disrupt the heart's electrical signals and lead to bradycardia:

• Bradycardia-tachycardia syndrome: This condition is characterized by alternating periods of very slow and very fast heartbeats, often originating from the sinus node.
• Heart block (atrioventricular block): In this case, the electrical signals don't move correctly from the atria to the ventricles, leading to a slow heartbeat. This can happen at different points within the heart's electrical conduction system.

Slow heartbeat (bradycardia) is frequently linked to problems with the heart muscle, often caused by heart conditions. Anything that raises your risk of heart disease can also increase your chances of having a slow heartbeat. These risk factors include:

• Age: As people get older, their risk of heart problems, and therefore bradycardia, tends to increase. This is because the heart, like other parts of the body, can naturally experience some wear and tear over time.

• High blood pressure: High blood pressure puts extra strain on the heart, making it work harder. This ongoing stress can lead to damage and potentially slow the heart's rhythm.

• Smoking: Smoking damages blood vessels and can harm the heart muscle. This damage can contribute to various heart issues, including bradycardia.

• Heavy alcohol use: Drinking too much alcohol can disrupt the heart's normal electrical signals, potentially leading to a slow heartbeat. Regular heavy alcohol use can also contribute to other heart problems.

• Illegal drug use: Many illegal drugs can negatively affect the heart's function, potentially causing irregular heartbeats or bradycardia.

• Stress and anxiety: While not a direct cause of heart damage, chronic stress and anxiety can increase the risk of heart problems. The body's response to stress can lead to elevated blood pressure and other factors that put a strain on the heart, increasing the risk of bradycardia.

Slow heartbeats (bradycardia) can lead to several problems. One common issue is frequent episodes of losing consciousness, called fainting. This happens because the heart isn't pumping blood effectively to the brain, causing temporary loss of awareness.

Bradycardia can also contribute to heart failure. This means the heart isn't strong enough to pump blood throughout the body efficiently. Over time, this can lead to symptoms like shortness of breath, swelling in the legs and feet, and fatigue.

In serious cases, bradycardia can result in sudden cardiac arrest (SCA) or sudden cardiac death (SCD). SCA is a sudden, life-threatening disruption of the heart's rhythm. If not immediately treated, this can lead to death. SCD is the death that happens as a result of this sudden cardiac arrest. It's crucial to seek immediate medical attention if you suspect these events are happening.

Taking steps to prevent heart disease might also help reduce the risk of a slow heart rate (bradycardia). The American Heart Association suggests several lifestyle changes:

1. Get Moving Regularly: Exercise is crucial for heart health. Talk to your doctor about the best types and amounts of exercise for you – it's personalized! Even moderate exercise, like brisk walking, can make a difference.

2. Nourish Your Body with Healthy Foods: A balanced diet is key. Choose foods low in salt and unhealthy fats, and load up on fruits, vegetables, and whole grains. Think of it like building your body with healthy materials.

3. Maintain a Healthy Weight: Being overweight puts extra strain on your heart. Work with your doctor to set realistic goals for your body mass index (BMI) and weight. Small, consistent changes are more effective than drastic ones.

4. Quit Smoking and Avoid Tobacco Use: Smoking is extremely harmful to your heart. If you can't quit on your own, reach out to your doctor or a support program for help. There are resources available to assist you.

5. Limit or Avoid Alcohol: If you do drink alcohol, do so in moderation. For healthy adults, this means no more than one drink a day for women and no more than two drinks a day for men. Be mindful of your intake.

6. Manage Stress Effectively: Strong emotions can impact your heart rate. Finding ways to manage stress is important. Increase physical activity, practice mindfulness (being present in the moment), and connect with support groups or friends. These can help.

7. Prioritize Sleep: Getting enough quality sleep is vital for overall health, including heart health. Most adults need 7-9 hours of sleep each night. Maintain a regular sleep schedule, even on weekends, to regulate your body's natural sleep-wake cycle. If you're having trouble sleeping, talk to your doctor.

If you already have heart disease:

8. Adhere to Your Treatment Plan: It's crucial to follow your doctor's recommendations precisely. Understand your treatment, and take all medications as prescribed.

9. Report Changes in Symptoms: If you notice any changes in your symptoms, or new symptoms arise, tell your doctor immediately. This is vital for monitoring your condition and managing any complications. Regular checkups are also important.

Doctors diagnose slow heartbeats (bradycardia) by checking you and listening to your heart with a stethoscope. They also ask about your symptoms and medical history.

To find the cause of the slow heartbeat, doctors might run some tests.

• Blood tests: A blood sample is checked for infections and to see if your body's chemical balance, like potassium levels, is normal. Blood tests can also check your thyroid function. Problems with the thyroid can sometimes affect your heart rate.

• Electrocardiogram (ECG or EKG): This is a common test for slow heartbeats. An ECG measures the electrical signals that make your heart beat. Small, sticky sensors (electrodes) are placed on your chest, arms, and legs. Wires connect these sensors to a computer, which displays a graph showing your heart's rhythm. This graph helps doctors see if your heart is beating regularly.

• Holter monitor: If a regular ECG doesn't show a problem, a doctor might suggest a Holter monitor. This is a small, portable ECG machine you wear for a day or more. It continuously records your heart's activity throughout your normal daily routine, which can help detect irregular heartbeats that might not show up during a short ECG.

• Stress test: Some irregular heartbeats are triggered or worsened by exercise. A stress test watches your heart's activity while you exercise on a stationary bike or treadmill. If you can't exercise, medicine that mimics the effects of exercise might be used instead. This allows doctors to see how your heart responds to exertion.

• Sleep study: If you have pauses in breathing during sleep (obstructive sleep apnea), a sleep study might be recommended. These breathing pauses can sometimes affect your heart rate. The sleep study monitors your breathing and heart rate throughout the night to look for these pauses.