Bradycardia: Symptoms, Diagnosis, & Treatment

Overview

Bradycardia is lower than the normal heart rate. Adults’ hearts at rest generally are able to beat around 60 to 100 times per minute. If you suffer from bradycardia your heart beats less than 60 times per minute.

Bradycardia is a serious issue if your heart is extremely slow and the heart isn’t able to supply enough oxygen-rich blood to the body. If this occurs you might feel tired, dizzy weak, or exhausted. Bradycardia can cause no signs or unexplained complications.

A heartbeat that is slow isn’t always an issue. For instance, a heart rate that is between 40-60 beats per minute is fairly common sleep. It can also be observed in certain individuals, in particular, especially young adults who are healthy and well-trained athletes¹.

If bradycardia has become severe A pacemaker implanted may be necessary to help the heart to maintain a normal rate.

 

Symptoms

A heartbeat that is slower than normal (bradycardia) could stop the brain as well as other organs from receiving enough oxygen. It could result in these symptoms and signs:

• Chest pain
• Memory problems or confusion
• Lightheadedness or dizziness
• It is easy to get tired during physical exercise.
• Fatigue
• Affliction (syncope) or close-to-fainting
• Breathing shortness

When is the best time to seek medical attention?

A variety of things can cause symptoms and signs of bradycardia. It is crucial to receive an immediate, accurate diagnosis and the appropriate treatment. Talk to your doctor when the child or you is suffering from signs of bradycardia.

If you experience a fainting spell, difficulty breathing, or chest pain that lasts longer than several minutes, contact 911 or call emergency medical services. Get emergency medical attention for anyone suffering from these symptoms.

Causes

Bradycardia is caused by:

• Heart tissue damage due to age
• Heart tissue damage from a heart attack or disease
• A heart disorder present at birth (congenital heart defect)
• Inflammation of the heart tissue (myocarditis)
• A heart-related complication that can be a result of surgery.
• A thyroid gland that is underactive (hypothyroidism)
• Chemical imbalances in the blood, for example, calcium or potassium
• Breathing pauses that are repeated in sleep (obstructive sleep apnea)
• Inflammatory diseases, like Lupus or lupus, are both inflammation-related diseases.
• Medicines, such as opioids, sedatives, and medications used to treat heart rhythm problems as well as high blood pressure, and various mental health conditions.

To better understand the cause of bradycardia it might be beneficial to understand how the heart normally beats.

The typical heart is comprised of four chambers: two chambers in the upper (atria) as well as two chambers in the lower (ventricles). In the upper right chamber within the heart (right atrium) is a collection of cells referred to as”the sinus node. The sinus node acts as the heart’s pacemaker. It is the source of the signal that triggers every heartbeat.

Bradycardia happens when the signals slow down or get blocked.

Sinus node problems

 

The majority of cases of Bradycardia begin in the heart area known as”sinus node”. In some people, sinus node problems cause alternating slow and fast heart rates (bradycardia-tachycardia syndrome).

Heart block (atrioventricular block)

Bradycardia can also happen if the electrical signals from the heart aren’t moving in a proper manner between those chambers in the top (atria) towards the chambers below (ventricles). If this happens it’s known as heart block or Atrioventricular block.

Heart blocks are divided into three major groups.

• Heart block of the first degree. In the mildest form, it is when all electrical signals originate from the atria and reach the ventricles, however, the speed of signaling is reduced. Heart block of the first degree rarely triggers symptoms and generally doesn’t require treatment if there’s no issue with electrical signaling.
• Heart block of the second degree. Not all electrical signals can reach ventricles. A few beats are missed which causes a slower and occasionally irregular heart beat.
• third-degree (complete) heart block. None of the electrical signals emanating from the atria can reach the ventricles. In this case, the ventricles are likely to beat by themselves, however at a very low rate.

Risk factors

Bradycardia can be linked to damaged heart tissue due to certain heart diseases. Anything that can increase the chance of developing heart issues increases the risk of developing bradycardia. Heart disease risk factors include:

• Older age
• High blood pressure
• Smoking
• Heavy alcohol use
• Illegal use of drugs
• Stress and anxiety

Lifestyle changes that promote health or medical treatments can reduce the risk of developing heart disease.

Complications

The possible complications of bradycardia are:

• Frequent fainting
• Heart is unable to pump blood enough (heart failure)
• Sudden cardiac arrest or sudden death

Prevention

Bradycardia is often caused by certain medications, especially when they’re taken in large doses. It’s crucial to take all medicines as prescribed. While bradycardia isn’t usually prevented, doctors suggest strategies to lower the chance of developing heart disease. Follow these heart-healthy guidelines:

• Regularly exercise. Your health care physician may provide suggestions on how much and which kind of exercise is the best for you.
• Consume a balanced diet. Choose a healthy low-fat, low-salt, and low-sugar diet rich in vegetables, fruits along with whole wheat.
• Maintain an ideal weight. Being overweight increases the likelihood of developing heart diseases.
• Maintain blood cholesterol and pressure under control. Make lifestyle changes and take the medications prescribed to control diabetes, high blood pressure, and cholesterol levels.
• Do not Smoke. If you need assistance in quitting smoking, speak to your doctor or health professional about programs or strategies to assist you.
• If you consume alcohol, do it in moderate amounts. If you choose to consume alcohol, you should do it in moderate amounts. For healthy adults, this could mean drinking up to one drink per day for women, and 2 drinks max per day for males. If you’re unable to limit your alcohol intake and you are struggling, speak to your health professional regarding a program that will help you stop drinking and control other behavior associated with alcohol use.
• Take care of anxiety. Intense emotions may alter the heart rate. A few ways to ease stress include regular exercise as well as joining a support network and experimenting with relaxation techniques like yoga.
• Check-ups are scheduled for the day. Have regular physical examinations and report any symptoms or signs to your physician.

Check and treat any existing heart condition

If you have already been diagnosed with heart disease There are ways to reduce your chance of developing bradycardia, or another heart rhythm condition:

• Follow the guidelines. Be sure you know the treatment strategy. Follow the prescribed medication as directed.
• Inform your doctor immediately of any changes. If your symptoms get worse or change, or you experience new symptoms, notify your doctor right away.

Diagnosis

In order to diagnose bradycardia, your doctor typically performs an exam of the body in addition to listening to your heart using the Stethoscope. They will ask you questions regarding your symptoms and medical background.

Your doctor might recommend tests to examine your heart rate to determine whether you suffer from an issue with your heart that could cause bradycardia. The blood tests can be performed to look for other issues that could cause slow heartbeats. These could include an illness an inactive thyroid (hypothyroidism) or an imbalance in electrolytes.

 

Tests

An electrocardiogram (ECG also known as an EKG) can be the most important test used to detect bradycardia. An ECG analyzes how much electrical energy is generated by the heart. The heart’s electrical activity is measured. The conductive patch (electrodes) can be placed over the chest, and occasionally the legs and arms. The electrodes are connected with wires to a computer which shows the results. It is possible to determine if the heart is beating too slowly or too fast, or not at all.

It is not possible to detect bradycardia until a slow heartbeat is observed in the course of the test. Your healthcare provider may suggest the use of a portable ECG device. Portable ECG devices include:

• Holter Monitor. Carried in a pocket or attached to the belt or shoulder strap it monitors the heart’s activity continuously for up to 24 hours.
• Recorder for events. This device is like the Holter monitor, however, it records only at specific intervals for a couple of minutes at one time. It’s more worn than the Holter monitor, which is typically 30 days. The typical user presses a button when you are experiencing symptoms. Some devices record automatically whenever an irregular heart rhythm is observed.

It is possible to combine other tests to determine the effects of bradycardia on you. The tests are:

• Tilt table. This test may aid your doctor in better understanding the way your bradycardia triggers fainting episodes. While you are lying flat on a table that is tilted to make it appear as if you’re standing up. The tilt test is conducted to determine whether any change in the position of the table results in fainting.
• Stress exercise test. It is possible to track your heart’s activity as you ride stationary bikes or run on the treadmill. If you’re having difficulty exercising or walking, a medication could be administered to stimulate the heart in a manner that’s comparable to exercising.

A sleep test may be suggested if your medical professional suspects that breathing pauses that are repeated while you sleeping (obstructive sleep apnea) can cause bradycardia.

 

Treatment

The treatment for bradycardia is based upon the intensity of the symptoms and the reason for the heart rate slowing. If you’re not experiencing any symptoms, treatment may not be required.

Treatment for Bradycardia may involve lifestyle modifications, medication adjustments as well as an implanted gadget referred to as a pacemaker. If a health issue is underlying like sleep apnea or thyroid disease that is causing the faster than normal heartbeat treatment for that issue could correct the bradycardia.

Medications

A variety of medications, such as those that treat other heart diseases, can trigger bradycardia. Be sure to let your doctor be aware of any medicines you are taking, even ones purchased without a prescription.

If you’re taking a medication that causes bradycardia your physician may suggest a lower dose or a different drug.

Other surgical procedures, or surgery

If other treatment options aren’t feasible and bradycardia symptoms become severe and severe, a device known as the pacemaker is needed to regulate the heartbeat. Pacemakers are only used when it is they’re required. If the heartbeats slow, the pacemaker sends electronic signals that signal the heart, which increase the speed of the beat.

Implanting a pacemaker requires surgery. A wire or two is placed through a vein underneath or around the collarbone. They are directed to the heart with an X-ray guide. The wire’s one end is secured to the proper location in the heart while the other is connected to the device (pulse generator) placed under the skin, beneath the collarbone.

A leadless pacemaker² is less invasive and usually requires a less invasive procedure to insert the device.