Episodes of slow heart rate

[Scout]

I've been having episodes of slow heart rate. Especially when exercising (I only do very mild exercise). 

About half an hour ago, I tried to use my bike pedals — the ones you use sitting down (can't think of the proper name) — and was going a very, very slow pace. Immediately, I started to feel dizzy. My BP when checked was 160/95, heart rate 43. 

As soon as I stopped and lay down, it returned to normal, BP 100/65 or so. Pulse normal. 

Does anyone have any idea what could be causing this only to happen during exercise, even very mild exercise. It's scaring me, to be honest, and I am worried there's something wrong with my arteries (seeing cardiologist in one month). 

The slightest bit of exercise makes this happen.  The low heart rate paired with the BP spikes is getting odder and odder. 

[Pistol]

Hello @Scout - this is odd, do you normally have bradycardia? An increase in BP is expected with exercise but I am not so sure about the bradycardia. Here is a link I found about this:

www.emergencymedicalparamedic.com/why-does-bradycardia-cause-hypertension/

It explains that hypertension CAN cause bradycardia and vice-versa. Also - I am wondering if you take any medications that could lower your HR? I used to get episodic bradycardia on Metoprolol which improved when I switched to another BB. Make sure you record all these findings and your symptoms - it will be very important for the cardiologist next month. Best of luck - keep us posted!!!!

[yogini]

It is normal for blood pressure to increase during exercise.   It seems your BP is increasing within the normal range for exercise.

https://www.healthline.com/health/blood-pressure-after-exercise

 If your blood pressure increases, it enables the heart to slow down.  That is why so many POTS patients benefit from treatments to increase blood pressure (or blood volume).   

It is always good to get it checked out by your dr when you are having new symptoms but these symptoms you are having may not be dangerous.

[WinterSown]

This sounds very familiar, I went through something like this last year. My EP slowly took me off of most of my heart medicines. I was getting stronger because of exercise and walking and so I didn't need such heavy doses. This may be a sign that you are getting better--talk to your cardiologist and see if you can cut some meds. 

[Scout]

12 hours ago, yogini said:

It is normal for blood pressure to increase during exercise.   It seems your BP is increasing within the normal range for exercise.

https://www.healthline.com/health/blood-pressure-after-exercise

 If your blood pressure increases, it enables the heart to slow down.  That is why so many POTS patients benefit from treatments to increase blood pressure (or blood volume).   

It is always good to get it checked out by your dr when you are having new symptoms but these symptoms you are having may not be dangerous.

Indeed, it's normal to a degree. But it's not normal for it to shoot up dramatically like mine does.

Systolic BP rises quite a bit during exercise, and that's fine. But diastolic BP is meant to remain largely unchanged, or even drop slightly, during exercise. Mine skyrockets into sometimes hypertensive crisis levels.

Today, for example, after a lukewarm bath, I blacked out with severely high BP and slow, irregular heart rate. This isn't good or normal. 

[Scout]

15 hours ago, Pistol said:

Hello @Scout - this is odd, do you normally have bradycardia? An increase in BP is expected with exercise but I am not so sure about the bradycardia. Here is a link I found about this:

www.emergencymedicalparamedic.com/why-does-bradycardia-cause-hypertension/

It explains that hypertension CAN cause bradycardia and vice-versa. Also - I am wondering if you take any medications that could lower your HR? I used to get episodic bradycardia on Metoprolol which improved when I switched to another BB. Make sure you record all these findings and your symptoms - it will be very important for the cardiologist next month. Best of luck - keep us posted!!!!

Thanks so much for the link Pistol. 

I am not on metoprolol anymore (it made me worse). Keeping a close record of my symptoms though for sure. I just had a bad episode of bradycardia, very high BP, and irregular heartbeat. Taking notes to ensure I bring this all up with the cardiologist. 

[Scout]

6 hours ago, WinterSown said:

This sounds very familiar, I went through something like this last year. My EP slowly took me off of most of my heart medicines. I was getting stronger because of exercise and walking and so I didn't need such heavy doses. This may be a sign that you are getting better--talk to your cardiologist and see if you can cut some meds. 

I'm not on any meds at present. 

I'd like to say that I'm getting stronger, but I don't think that's it sadly. My BP is rising to not normal levels during the slightly exercise. 

[p8d]

This happens to me all the time.  When my BP goes up HR goes down.  I took a 7 minute walk outside with the PT last week and we checked my vitals when we got back in my BP was 166/93 HR 59.  The HR was fine.  When I was having more supine hypertension before I started carvedilol my BP would be 150-160/80s with HR in the 40s.  My cardiologist switched my alpha and beta blockers, not at the same time, and things are better controlled now.  I was told sitting BP should be 150 systolic or less and not to worry about it unless it gets over 180 .  This is not while exercising.  My PT wasn’t worried about my BP last week.  Talk to your cardiologist about it but don’t freak yourself out unless you hit crisis territory.

[Outaker]

Hope this answers your question- 

• The overall cardiovascular response is increased cardiac outputand systemic vascular resistance, which results in an elevation in arterial blood pressure. Heart rate, although initially stimulated by norepinephrine, decreases due to activation of baroreceptors and vagal-mediated slowing of the heart rate in responses to the elevation in arterial pressure.

[Outaker]

Beta blockers can make things a lot worse so be careful -

[yogini]

On 6/30/2019 at 10:05 PM, Scout said:

Indeed, it's normal to a degree. But it's not normal for it to shoot up dramatically like mine does.

Systolic BP rises quite a bit during exercise, and that's fine. But diastolic BP is meant to remain largely unchanged, or even drop slightly, during exercise. Mine skyrockets into sometimes hypertensive crisis levels.

Today, for example, after a lukewarm bath, I blacked out with severely high BP and slow, irregular heart rate. This isn't good or normal. 

Drs usually have cancellations, so maybe you could try to move up your appointment.  If you are blacking out, having irregular heartbeats and BP numbers which you think are hypertensive crisis (though I am not sure exercise is the right place to measure that, especially when it comes right down when you stop) it would probably be best to be seen sooner if you can manage it.