Slow Heart Rate

[Chrissy]

I've been having relatively low heart rate readings, at least for me. I used to register between 90 and 150, now I spend most of the time in the 50s and up to 116. When I emailed my dysautonomia doctor, she said that that could be a side effect of Nadolol and asked if I was experiencing dizziness and shortness of breath. No more than normal. I'm also experiencing "ice in my lungs", fatigue, cough, and tightness. But I have an appointment with a pulmonologist in September to follow up on "a small ? mass on the mid lung". Could the low hr be contributing to the lung issues or is the lung issues causing the low hr? I don't want to mess with my meds unless I'm sure that's the problem, but I'm tired of feeling like this. Any advice?

[potsgirl]

Chrissy,

I also have low heart rates, and wouldn't change your meds until you get more answers. I have cardiomyopathy and a pacemaker, so I'm very careful about changing meds. Also, there are so many medications out there that can lower your BP and heart rate, that I think you should really wait until you see your doctor. Hope you feel better soon!

Cheers,

Jana

[skyblu]

I was just going to start a thread on low HR. I'm not on any meds except Ativan for sleep and I have episodes low heart rates that can last for days. In the low 50's and high 40's when I sleep. I think I feel more sluggish when my HR is low all the time.

My cardio doesn't seem too concerned....he thinks it's all part of my dysuatonomia....in my case erractic BP and HR. But I'm going to email him tomorrow because I'm not sure when low becomes too low.

[potsgirl]

My heart rate was going into the 30s and low 40s when I wore a holter monitor, which is of course Bradycardia, and I ended up with a pacemaker. Low heart rates can make you super fatigued! Your numbers seem pretty low to me. I think it's a good idea to call your cardio again, especially if you're having symptoms.

Good luck,

Jana

[skyblu]

Thanks Jana. I wore an event monitor for a month in March but that was during a time when I was having tachy episodes. I don't know if it picked up any brady episodes as well. Holtor monitors and event monitors in the past have picked up some brady episodes but for some reason my cardio sort of brushed it off and wasn't concerned.

The thing that's different now is it's constant. Do cardiologists not consider a constant HR in the low 50's or high 40's to be bradycardia,..? LOL...considering I'm not an athlete.

[erikainorlando]

I have had times when my hr has been very low but I think it is due to the toprol. Now having said that very low for me is around 55-60. But I have to add that I feel pretty bad when my hr is not high enough. I mean I am not happy when it is over 110. But I do almost think the low hr makes me feel worse...the high hr I can sit and pull it back togehter. The low hr...well I don't know how to fix that...

Good luck....at least it sounds like you have a good doc that you can emial and ask questions of..

Erika

[potsgirl]

Yes, heart rates that low should certainly be considered bradycardia!

[skyblu]

Erika.. Yes... I feel fortunate to be able to email my cardiologist. It beats having to go in for every little question or when my symptoms change which seems to happen frequently.

Jana, thanks...I always thought low 50's was considered bradycardia. I have a feeling my cardiologist is going to say there's nothing he can do or will do for the low HR unless I'm symptomatic which to him probably means passing out.

[potsgirl]

Skyblu,

Both Florinef and Midodrine are meant to help regulate your BP. In my case, they're supposed to help raise my BP. I can't tolerate Florinef well, but I take Midodrine sometimes when I really need some extra energy during the day. Also, drinking lots of water/Gatorade, eating a lot of salt, and sometimes even raising the head of your bed can help raise your BP. Please PM me if you'd like more info.

Cheers,

Jana

[Chrissy]

Just got off the phone with my cardiologist's nurse. They want to lower my nadolol to a half in the morning and a whole at night. I don't believe its my nadolol that is the problem, so to prove a point I'm thinking cold turkey off the nadolol and see if my heart rate goes up and if it doesn't..... She also said that 50 is not low and that unless I'm passing out from it being that low there shouldn't be a problem. I'd like to see her go through one day of what I'm feeling right now. I'm so tired I can't even get food down. Then it doesn't help I'm dealing with pulmonary issues and my oxygen is only 92-94. I'm so frustrated. Please advise.

[flop]

Chrissy,

I've posted in your asthma thread too. I would listen to what your cardiologist has advised. Too much Nadolol will lower your heart rate and make you feel tired. If you could possibly have asthma then the Nadolol could be making the asthma worse. Please don't suddenly stop your Nadolol without talking to a doctor as beta-blockers can have funny re-bound effects if stopped abruptly.

Hope you feel better soon,

Flop

[potsgirl]

Chrissy,

If you go to Webmd.com or some of the other reputable medical sites, it explains that bradycardia is any heart rate that is below 60, since the average HR is 60-100 in most adults. Athletes, or people who take certain medications or have a heart/electrolyte problem may also have a lowered HR, among other causes. Usually they won't do too much unless you can link your symptoms with your lowered HR. Also...When your HR gets low, what happens to your BP? I have a very low BP also. And I second Flop's recommendation to not just stop your Nadolol.

Best Wishes,

Jana

[Chrissy]

Okay, I read webmd.com about bradycardia. It caught my eye that high potassium can trigger an episode. I just picked up my labs ordered by my gastro doctor, which I had to request be run. My potassium was bordeline high. He hasn't been able to find the results to let me know his impression, but I remember when I first got diagnosed they said high salt, low potassium or something like that. I also seem to get sick when I eat bananas, but my sister-in-law was pushing me to eat a healthy diet and quit skipping meals. She couldn't understand why bananas would make me so sick so she told me to try one and let her know how I react. Sick again, so....But I'm pretty sure they ran my electrolytes in the ER and my potassium went down some. Could this be causing my problems or at least contributing?

[potsgirl]

I can't eat bananas either! They make me really sick to my stomach, along with OJ. If your potassium is too low, I would think that would exacerbate your low heart rate. Could you let us know what happens to your BP when you're HR is low? Have you worn a Holter Monitor?

jana

[Chrissy]

Due to endocrine issues and the increase in weight, my b/p has been running in the prehypertensive - stage 1 hypertensive range. With the low heart rate, its running 102/60 to 119/70, I guess that would be considered a normal b/p. I wore a holter moniter 5 years ago before I got diagnosed the hr ranged from 48-150 and the conclusion was a "rare ventricular ectopy" or something like that. I asked my current cardio to do a holter and his nurse said "we know your hr is in the 50's and a that is all a holter will tell us, so there is no need to do one." I personally disagree. My hr may spent alot of time in the 50's but it still spikes into the 100's too. And webmd.com made it sound like a holter is a portible ekg. I think its important to see how my heart is responding to the highs and lows. As for potassium, mine is borderline high.

[erik]

Sorry I don't have any directly helpful tips, but I'll throw out some factoids & opinionoids anyway!

I think potato's have more potassium than a banana anyway, so that could be an option if hunting for K! (Just as chicken has more L-Tryptophan than turkey... and neither actually make you sleepy... but somehow these things get out there and live on!) Anyway, look to details of the nutrition and you're likely to find something to choose from if you suspect a dietary shortage or sensitivity.

I took K and magnesium supps in moderate amounts while taking fludrocortisone (since it instructs kidney's to hold salt & dump potassium), but it's not necessary unless you get bad electrolyte measurements (the doc should monitor electrolytes and advise especially if a med has such known side effects).

If you're getting bradycardia directly from electrolyte disturbance you are in the 'serious medical issue' realm and need to address it pronto via your doctor. If it is something else, like hormone imbalance or neurological (vagus nerve stimulation does this) then they seem to write it off (but probably shouldn't if you have symptoms).

I did a steady 40bpm in the ER on EKG not long ago, yet athletes I talk to say they only got into the 50's with hard work. Perhaps the fact that my heart rate doubles or triples immediately upon standing means I am "exercising" much of the time and am hence, a world class athlete. Anyway, 25bpm is the world record RHR I read about for a healthy person (a top-level athlete). In athletes, it is a complicated & controversial issue and ties in with sudden death (via hypertrophic cardiomyopathy & arrythmias)... and you basically have to decondition your self to get treatment.