Bradycardia

When your heart rate is slow, or less than 60 beats per minute, it is called bradycardia. Bradycardia can be normal, caused by medicines, or a sign of a disease. The slow heart rate may not be constant. It can come and go. It's a concern when it is very low, or you have symptoms.

Symptoms

The following are symptoms of bradycardia:

  • Heart rate less than 60 per minute

  • Dizziness or feeling lightheaded

  • Weakness

  • Trouble breathing

  • Fainting

  • Sleepiness

  • More trouble exercising than usual because of tiredness (fatigue)

  • Confusion or trouble concentrating

Causes

Bradycardia can have many causes. Some can be related to your heart, but some may be related to other things.

Non-heart-related causes:

  • Advanced age

  • Side effect of certain medicines. These include beta-blockers, calcium channel blockers, digitalis, clonidine, lithium, and medicines to treat arrhythmias such as amiodarone.

  • Health conditions such as low blood sugar (hypoglycemia), low thyroid (hypothyroidism) , electrolyte disorder,  low body temperature (hypothermia), and sleep apnea

  • Athletes, especially long-distance runners, may have a slow heart rate. This can be normal.

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  • Brain injury such as stroke or bleeding inside the brain

Heart-related causes:

  • Coronary artery disease. This includes angina or past heart attack (acute myocardial infarction).

  • Heart valve disease

  • Heart muscle disease (cardiomyopathy)

  • Congestive heart failure

  • Sick sinus syndrome. This is when your heart's natural pacemaker is no longer working correctly.

  • Heart block. This is when your heart's natural electrical pathways no longer work correctly.

  • Diseases that enter the heart such as sarcoid

  • Heart infections

Sometimes the cause for the arrhythmia can't be found.

Bradycardia that causes symptoms is sometimes reversible, and can be treated with medicines. When more severe bradycardia continues, you may need a pacemaker. When the bradycardia doesn't cause symptoms, your doctor may decide to watch it over time.

Home care

The following will help you care for yourself at home:

  • Go back to your usual activities when you are feeling back to normal.

  • If you have any of the symptoms below when you exert yourself, stop. Don't exert yourself until you have seen your doctor for an assessment.

  • Work with your doctor on any needed lifestyle changes. These might include changing your diet, stopping smoking if you are a smoker, and starting a planned exercise program.

Follow-up care

Follow up with your doctor, or as advised.

Call 911

Call 911 if any of the following occur:

  • Chest pain

  • Trouble breathing

  • Slow heart rate with dizziness or lightheadedness

  • Fainting or loss of consciousness

  • Chest pain that spreads to the shoulder, arm, neck, or back

  • Slow heart rate (under 50 beats per minute) if it happens along with other symptoms

When to seek medical advice

Call your healthcare provider right away if any of the following occur:

  • Occasional weakness

  • Dizziness

  • Lightheadedness

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