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Feel like I am in a fog, low heart rate, get panic attack. Normal?

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Practicing since : 1981
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Sometimes upon waking I feel like I'm in a "fog" and my heart rate is around 42. As I get up and move around, it gets to 65 at most, ten usually at some point I feel a panic attack and like things finally "kick in". Is this normal?
Posted Fri, 28 Sep 2012 in Hypertension and Heart Disease
Answered by Dr. Anil Grover 1 hour later
Hi there,
Thanks for writing in.
I am a qualified and certified cardiologist. I read your mail with diligence.
Heart rate of 42 is not abnormal per se but it is associated with foggy feeling you describe and inability of heart rate to rise above 65 denotes Chronotropic Insufficiency which is symptomatic. Meaning thereby you need urgent medical attention. If there is no temporary cause, then perhaps a Permanent Pacemaker is required. In short, if your heart rate is now 42 during evening time and you have slightest of symptoms, please have yourself taken to ER. Let doctor decide whether you need a temporary pace maker support while you are evaluated for tachy XXXXXXX syndrome (you mentioned panic attacks) or due to Celexa induced side effects. Take this as an emergency please. Good Luck.
With best wishes.
Dr Anil Grover,
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by
Follow-up: Feel like I am in a fog, low heart rate, get panic attack. Normal? 5 minutes later
This has happened multiple times in my life over the last 20 years or so. I have. Even to doctors before with PVCs and they all say that I have a slow heart rate because I was so athletic in my younger years. Generally when lying down I am in the 50-55 range but rarely, I will get down to 42-45 and feel half asleep. It's very scary. I don't know why it's happening randomly every so often. Could sleep apnea be a factor?
Answered by Dr. Anil Grover 1 hour later
Thanks for writing back.
You are right about athlete remember XXXXXXX Spitz (who won 7 Golds in Olympics) his basal heart rate was 37 ! That would not worry how point is how much you can raise it by exercise if 65 is the limit I would like to exclude potential sick sinus syndrome. So my suggestion is get yourself investigated.

No sleep apnea can not be a factor in the history you have described so far.


Anil Grover
Above answer was peer-reviewed by
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