Have you ever felt your pulse and thought, "Wow, that's really slow"? Or have you ever gotten a 'low heart rate' alert from your smart watch? Maybe you've just felt dizzy and someone said, "My heart rate is a little slow." This slow heartbeat is actually what we're talking about today, a condition called ``Bradycardia'' in medical terms.
Simply put, what is Bradycardia?
Bradycardia, or bradyarrhythmia, is when your heart beats less than 60 times per minute when you are at rest, that is, when you are just standing still, not running or jumping. The normal heart rate of a healthy adult is between 60 and 100 beats per minute. So when it is less than 60, we call it a slow heart rate, or bradycardia.
But the most important thing here is that every time the heart rate drops below 60, it is not a disease or something to be afraid of. Think of someone who exercises well and plays sports. We call them `(athletes)`. Because their hearts are used to working very efficiently, they can pump the amount of blood needed by the body in one beat. Therefore, even if their hearts beat fast, there is no problem for the body. Also, it is normal for the heart rate to slow down a little even when we are sleeping well. This is also called `(sinus bradycardia)`. That means that the heart beats naturally, without any problem in the electrical system of the heart.
However, if you are not an athlete and you feel that your heart rate is consistently low, it is best to talk to a doctor about it.
What are the symptoms of someone with bradycardia?
Many people, especially those athletes mentioned earlier, have low heart rates and don't experience any symptoms. They don't have any problems. But sometimes, even if there are no symptoms, there may be a reason for internal treatment.
But when the heart rate slows down, meaning the heart can't pump enough oxygen-rich blood to the body, certain symptoms may appear. These are the symptoms:
| Symptom | A simple explanation |
|---|---|
| Dizziness or lightheadedness | A condition caused by insufficient blood flow to the brain. You may feel like you're going to fall when you're standing. |
| Fainting | If the heart rate slows down too much, blood flow to the brain may be temporarily disrupted, causing loss of consciousness. |
| Confusion or difficulty concentrating | Because it affects brain function, it can be difficult to concentrate and remember things. |
| Shortness of breath | When the body's tissues don't get the oxygen they need, they try to breathe faster to compensate. They feel tired even after doing a little work. |
| Chest pain | This kind of pain can occur when the blood supply to the heart decreases. |
| Fatigue | You may feel tired and sleepy all the time because your body's muscles and organs don't get the energy they need. |
| Heart palpitations | Sometimes the rhythm of your heart may feel irregular, like it skips a beat, or it may feel like it beats too hard all at once. |
Important: If you know that your heart rate is low and you have any of these symptoms, it is essential to seek medical advice immediately.
Why does the heart rate decrease like this? (Reasons)
The heart is not just a ball of meat. It has a very complex electrical system inside it. These electrical signals are what make the heart beat in a rhythm. The main cause of bradycardia is when there is a problem with this electrical system. It's like when the internet in our house becomes slow, or the TV loses signal.
There are two main issues affecting this:
1. Sinus node dysfunction: The heart has a part that acts like a natural pacemaker. It's called the sinus node. It gives the signal to the heart to beat at a certain rate. When this node doesn't work properly, the heart rate slows down.
2. Heart block: This is when the electrical signals from the upper chambers of the heart (atria) do not travel properly to the lower chambers (mitra). This creates a kind of `traffic block` on the signal path.
Okay, now let's see what other reasons this electrical system can become disrupted.
- Aging: After the age of 70, the heart's electrical system can naturally weaken a bit.
- Some medical conditions:
- Heart disease: Things like previous heart attacks, cardiomyopathy, and congenital heart disease.
- Underactive thyroid: When this hormone decreases, the heart rate, like everything else in the body, slows down.
- Electrolyte imbalances: This condition can occur if there is an increase or decrease in electrolytes, such as potassium, in the blood.
- Obstructive sleep apnea: This condition, in which breathing stops while sleeping, can cause a decrease in heart rate.
- Infections: Some infections, such as Lyme disease and Chagas disease, can affect the heart muscle and cause this condition.
- Other diseases: Diseases that cause inflammation in the body, such as rheumatoid arthritis and lupus.
- Certain medications: Medications such as ``beta-blockers'' and ``calcium channel blockers'' for high blood pressure, medications for other heart rhythm problems, and medications for some mental illnesses can also cause a slow heart rate as a side effect.
- Heart surgery: This condition can occur as a complication after some heart surgeries.
How does a doctor find this?
When you go to see a doctor, he or she will first ask you about your symptoms in detail. He or she will ask you things like how long you have had these problems, how long they have lasted, and when they are worse (e.g., when you exercise, when you change positions). So, if you can, it can be very helpful to write these things down in a notebook.
Then you will be examined and, if necessary, ordered to undergo several tests such as:
- ECG (Electrocardiogram): This is the most important test. It shows the electrical activity of your heart over a period of about a minute. However, if you are unable to have this done while you are having symptoms, the problem may not be recorded on the ECG.
- Ambulatory Monitoring: This is like a small ECG machine that you take home. It is attached to your body for 24, 48, or even longer hours. It continuously records your heart rhythm while you go about your daily activities.
- Blood tests: Check things like body salt levels and thyroid hormone levels.
- Echocardiogram: This is a `scan` of the heart. It helps to see things like the structure of the heart and the function of the valves.
- Exercise stress test: An ECG is taken while you exercise to see how your heart responds to stress.
- Sleep study: This test may be recommended if you suspect you have sleep apnea.
What are the treatments for Bradycardia?
Treatment depends on the cause of your slow heart rate and how it is affecting your body.
1. Changing medications: If this condition is caused by a medication you are taking for another condition, your doctor may be able to reduce the dosage or prescribe a different medication. Never stop or change medications on your own.
2. Treating the underlying condition: If it is a thyroid problem, medication can be given to treat it, and if it is a salt imbalance, correcting it can completely cure the condition.
3. Emergency medications: If symptoms worsen and you are hospitalized, medications such as atropine are given through an IV ( saline ) to immediately increase the heart rate.
4. Permanent Pacemaker: If the heart's electrical system is permanently weakened due to aging or another incurable cause, the best solution is to install a pacemaker. This is a small battery-like device. It is implanted under the skin of the chest through a minor surgery. Whenever the heart rate drops below the desired level, this device sends a small electrical signal to restore the heart's rhythm.
When should you see a doctor? When is it an emergency?
Regardless of whether you have bradycardia or not, it's a good idea for everyone to have a medical checkup at least once a year. It can help identify some problems before symptoms appear.
However, in the following cases, you should seek immediate medical attention . If possible, go directly to a hospital's Emergency Treatment Unit (ETU) .
- If you have a slow heart rate, along with symptoms such as chest pain, shortness of breath, severe dizziness, or fainting .
- If your heart rate is less than 40 beats per minute (unless this is normal for you).
- A heart rate that drops below 30 beats per minute can be dangerous because the brain may not receive the necessary amount of oxygen.
Take-Home Message
- Bradycardia is when your heart beats less than 60 times per minute when you are at rest.
- This is not always a dangerous condition. It is common for athletes and during sleep.
- If you have symptoms like dizziness, nausea, difficulty breathing, and chest pain, it could be a serious condition.
- If you feel your heart rate is low and you have symptoms, see your doctor immediately.
- When the cause is found and treated, this condition can often be completely cured or well controlled.
- Do not stop taking any medication or change the dosage without your doctor's advice.
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