Bradycardia means your heart beats less than 60 beats per minute (BPM). It is considered an arrhythmia or abnormal heart rhythm because the typical adult heart rate is between 60 and 100 BPM.
Is it an emergency? It depends. Some very physically active people have heart rates lower than 60 and can be diagnosed with bradycardia, but because of their health and fitness, the condition isn’t a problem for them. Their hearts are simply more efficient than the general population.
However, bradycardia can be a serious problem if the low rate keeps the heart from pumping enough blood to meet your body’s demands. Let’s dig deeper.
What Is Bradycardia?
As stated above, bradycardia is a condition in which the heart beats slower than 60 beats per minute. The primary organs affected by bradycardia are the heart and brain, but it is not a problem for everyone who has it.
The brain requires 15% to 20% of the blood coming from the heart — inefficient blood flow can result in memory problems and other illnesses. When the heart receives less blood than it requires, an individual may feel chest pain or become short of breath.
Anyone of any age or background can have bradycardia, but the condition is more common in people over 65 at about one in 600 individuals. However, someone with bradycardia may not have noticeable symptoms, so that the number may actually be higher. Many adults move into bradycardia during deep sleep but have no problems.
Bradycardia is less common in children and young adults unless they have a genetic defect, injury, or other condition that causes their heart to beat slower than expected.
If a doctor finds that bradycardia is a symptom of another condition, treating that condition likely eliminates the bradycardia. Suppose bradycardia is the primary condition and is causing illness. In that case, it is treated with medications to speed up the heart.
The Symptoms of Bradycardia
Since bradycardia affects the brain and heart, many symptoms are related to those organs. The symptoms include the following:
- Chest pain (angina)
- Shortness of breath (dyspnea)
- Heart palpitations – the unpleasant feeling of your own heartbeat without using your hands to feel your pulse
- Fatigue
- Confusion
- Memory problems
- Difficulty concentrating
- Irritability, agitation, or other personality changes
- Dizziness, lightheadedness, and fainting (syncope)
These symptoms are not specific to bradycardia, and many can be present at once.
Causes of Bradycardia
Health conditions and medications can contribute to bradycardia. Smoking or vaping is a risk factor.
Electrolyte deficiencies, particularly calcium, potassium, and magnesium, can slow your heartbeat. So can infections, especially by the bacteria that cause strep throat, which can damage heart valves if not treated quickly enough.
Lyme disease (borreliosis), a bacterial infection spread through tick bites, and Chaga’s disease, a parasitic infection caused by bites from the so-called “kissing bug,” also cause heart damage that results in bradycardia if the diseases are not treated as soon as possible.
People suffering from anorexia nervosa can develop bradycardia due to nutritional deficiencies, including low electrolyte values.
Inflammation of the heart can also slow its rate. Types of inflammation include:
- Endocarditis – an inflammation of the inner heart lining.
- Myocarditis – an inflammation of the heart muscle itself.
- Pericarditis – an inflammation of the pericardial sac that holds and cushions the heart.
Your heart has a natural pacemaker called the sinoatrial (SA) node, a cluster of cells regulating the heart’s electrical system, telling the atria and ventricles to squeeze at the right time and in the appropriate rhythm.
Sick sinus syndrome occurs when the SA node malfunctions, which can happen due to age (especially over 70), blood pressure medication, previous heart surgery, and atherosclerosis. Other prescription drugs, including beta-blockers, calcium channel blockers, anti-arrhythmia drugs, narcotics, lithium, depressants, and cannabis can also cause bradycardia.
Heart surgery to repair congenital heart conditions and valves or valve replacement can result in bradycardia, as can radiation therapy for cancer. Other conditions that can lead to bradycardia include:
- Heart attack or failure
- Coronary artery disease (CAD)
- Duchenne muscular dystrophy
- Long Q-T syndrome
- Lupus
- Rheumatoid arthritis
- Scleroderma
- Hypothermia
- Hypothyroidism
- Sleep apnea
- Intracranial tension – too much pressure on the brain from swelling, bleeding, or other causes.
As you can see, a lot of things can cause bradycardia. The first step to treatment is to get a correct diagnosis.
Diagnosing Bradycardia
A bradycardia diagnosis is based on a physical examination, an electrocardiogram (EKG or ECG), and blood tests.
During a physical exam, the doctor looks for visible signs of problems, while the EKG measures the electrical activity of the heart and shows it as a graph on a computer screen or strip of paper. Lab tests check electrolyte levels, thyroid hormone levels, and troponin, a primary indicator of a heart attack.
The doctor may also order a toxicology screen to look for drugs and other substances that might contribute to an abnormally slow heart rate.
Treatment and Management
If the patient has no symptoms, doctors don’t usually treat bradycardia. If the patient is symptomatic, the doctor can provide treatment to manage and sometimes cure the condition. Most treatments are effective immediately.
Treating any underlying condition that causes bradycardia can also eliminate it.
Medication and pacemakers are the two treatments typically used to manage bradycardia. If the low heart rate causes extremely low blood pressure, the patient can receive atropine, which causes the heart to beat faster. There are also oral medications that can improve heart function.
Pacemakers can be temporary or permanent, depending on the need. Pacemakers take over from the SA node to regulate the heart’s electrical system. Some pacemakers only activate when the SA node malfunctions, while others are always active.
You can avoid bradycardia caused by recreational drugs, such as alcohol, narcotics, and cannabis-based drugs. If you have an infection or suffer from anorexia nervosa, prompt treatment can alleviate the concern of bradycardia.
When to Go to the ER for Bradycardia
If you have never been diagnosed with bradycardia and develop the symptoms listed above quickly, or if your symptoms worsen or change suddenly, get to the emergency room as soon as possible.
If you experience any of the following, get immediate medical treatment:
- Chest pain (angina)
- Shortness of breath (dyspnea)
- Dizziness, lightheadedness, and fainting (syncope)
These are all symptoms of a severe issue that requires emergency treatment.
Contact Family First ER
Family First ER is fully staffed with experienced healthcare professionals who are ready to treat bradycardia anytime, 24 hours a day, seven days a week. You need immediate care to achieve normal heart rhythm, identify the cause, and prevent further injury.
If you have any questions, contact us.