Sign-in to Ask A Doctor - 24x7
OR
Sign in with GoogleGet your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
What Causes Low Resting Heart Rate?
HI. I am 47 generally good health in past except for low iron and slight anemia from time to time. I run 2 times a week and other sport when I can. While on ski holiday 4 months ago experienced extreme fatigue, totally breathless, having to stop at every turn, legs like lead. Normally can ski whole mountain without stopping. Blood test on return showed slight anemea but not enough to explain the above. Since then I have had increasing tiredness, feeling unwell, periods of dizziness, breathlessness when running or just 2 flights of stairs, unable to concentrate, periods of confusion. GP recently tested BP and commented heart rate low. Routine ECG seemed normal. Home BP and pulse are typically 106/69 HR 41 at rest. If I climb the stairs 2 times, breathless, my readings are 133/76 HR 42. Sometimes my heart rate drops more, has been down to 35 after climbing stairs also HR becomes quite eratic. Went for a hard run. Immediate at end 188/80 HR 98 (feel terrible). 1 hour after run 104/66 HR 63 (feel fantastic!). HR gradually drops to 44. Generally at rest my heart rate is never above 45. GP seems to think I am just suffering stress and low HR is down to excercise. I know I shoudnt feel so bad. Should I be concerned?
Mon, 28 Sep 2015
Greetings. Thank you for your question and welcome to HCM. I carefully read your query.
Normal heart rate in the population worldwide is standardized to 60-100 heart beats per minute. Indeed, sportsmen and those who have had vigorous physical activity throughout life have lower heart beat figures, but it is accepted down to 48 beats per minute. In some cases, during rest or sleep even down to 45 beats per minute.
However, when there is bradicardia, lower than these figures, that also produces symptoms such as dizziness, fatigue, weakness or blurry or dark vision, some other tests should be undertaken and the pacemaker implantation indication should be taken into consideration. In your case, from my experience, I would comment a heart beat of 45 beats per minute as normal, if I would find absence of the above described symptoms. Therefore, I would recommend you to be put on a 24- or 48-hour Holter rhythm monitor registration, to see your heart rate to how low it goes during various moments in a day, and if there is any conduction disturbance some time in a day. If there are lower than 40 beat per minute episodes, and the symptoms persist, then pacemaker implantation is indicated. You can further discuss this with your treating cardiologist.
I hope I have been of help.
Best regards,
Dr. Meriton
Normal heart rate in the population worldwide is standardized to 60-100 heart beats per minute. Indeed, sportsmen and those who have had vigorous physical activity throughout life have lower heart beat figures, but it is accepted down to 48 beats per minute. In some cases, during rest or sleep even down to 45 beats per minute.
However, when there is bradicardia, lower than these figures, that also produces symptoms such as dizziness, fatigue, weakness or blurry or dark vision, some other tests should be undertaken and the pacemaker implantation indication should be taken into consideration. In your case, from my experience, I would comment a heart beat of 45 beats per minute as normal, if I would find absence of the above described symptoms. Therefore, I would recommend you to be put on a 24- or 48-hour Holter rhythm monitor registration, to see your heart rate to how low it goes during various moments in a day, and if there is any conduction disturbance some time in a day. If there are lower than 40 beat per minute episodes, and the symptoms persist, then pacemaker implantation is indicated. You can further discuss this with your treating cardiologist.
I hope I have been of help.
Best regards,
Dr. Meriton
I find this answer helpful
Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
This is a short, free answer.
For a more detailed, immediate answer, try our premium service
[Sample answer]
Related questions you may be interested in
Recent questions on Heart rate
Loading Online Doctors....