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How are heart blocks and low pulse treated ?

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Female. Age: 40. Height: 5'5". Weight: 120. No children. General health, very good. Have been physically active, normal/low weight for whole life. Health history: smoked (off and mostly on) ca. 1 pack/day for 8-9 years (from age 17-26). Was told I had a heart murmur by a doctor in Germany, during an exam when I entered the country to be an au pair, at age 24. Was on meds for ADD/mild-moderate depression from 1998-2006 (ages 27-35). These included prozac, wellbutrin, and dexedrine. Usually the dexedrine was prescribed with one other anti-depressant. Took relatively low dosage amounts of these meds. Have been physically active most of life, vegetarian since age 23. Have had heart rate measured about 3 times in the last 5 years, each time the rate was between 31-33 bpm. I remember my resting heart rate in high school was around 60; I was active then as well, perhaps more so (dancer). No health insurance. Have only needed a doctor for trauma (bike, car accidents), broken bones, (and chiropractor), for as long as I can remember.

I am a Bikram yoga teacher (hot yoga). I love this yoga, have practiced it for the last nine years, and like to give 110% all the time in class. Started off practicing 6 days a week, 90 minutes each. Now practice closer to 4 days a week, due to schedule. From the beginning, the heat has been the biggest challenge for me. I've always seemed more prone to dizziness, near fainting, and difficulty breathing than all but the most obese, out-of-shape students. Even first-time students handle the heat better than I do. I realize I am working harder than most students, but even the other teachers don't struggle with the heat like I do. It's to the point of embarrassment now, as I have to sit down during certain highly-cardio parts of class (standing postures, challenging heart, change in blood flow from one side of body to other, high exertion, and change in level of head). Once we get to the floor series, everything is better, though very high heat and especially high humidity can make even the floor series postures miserable for me.

Not all hot yoga studios are equally hot and humid. Some studios I do fine in. In really hot/humid studios, I have spent as much as 1/2 or more of the class on the floor, trying to breathe through my nose and not pass out.

Is there anything I could say to other instructors/employers so that they know I am not a total wimp? I really don't want to go to the doctor over this, as I still have no health insurance, and if/when I do try to get insurance, any prior visit or mention of this condition will count against me. Thank you so very much.
Posted Fri, 13 Apr 2012 in Heart Rate and Rhythm Disorders
Follow-up: How are heart blocks and low pulse treated ? 5 minutes later
P.S. Forgot to mention that my heart beat has been irregular for several years now. Or, as my boyfriend once said, it can sound like "a drunken 3-legged race." Sometimes, though, it can be normal. Sometimes, it can be normal, and then an extra beat or etc. Thanks!
Answered by Dr. Rakhi Tayal 1 hour later

Thanks for writing to us.

Having a resting heart rate of 30 bpm is not normal at all. Added to it an irregular heart beat is even more a danger sign. You might be suffering from heart block.
During yoga in hot and humid environment, your heart has to race more, which it is not able to and makes you feel dizzy due to decreased blood supply to your brain.
Your problem needs an immediate medical attention and you need a complete cardiac work up done under the care of an expert cardiologist.

I hope my answer and recommendations are adequate and helpful. Waiting for your further follow up queries if any.


Above answer was peer-reviewed by
Follow-up: How are heart blocks and low pulse treated ? 5 hours later
Dear Dr. Tayal,

Thank you very much for your response. I do have a few more questions.

I have been living with these symptoms for several years now. What could be the possible consequence(s) of not getting immediate medical attention and a complete cardiac work up?

I know some athletes do have very low heart rates as well.

I also forgot to mention that it is not unusual when I am just in my home or etc, for me to get quite dizzy when I stand up. I usually sit immediately down, or hold on to something until it passes quickly away. I would also say that I do seem to deal with general fatigue more than other people, especially considering my healthy eating habits and regular exercise.

I read online that these are normal symptoms with bradychardia.

Have I been doing the correct thing by sitting out a posture or two during yoga class, when I feel as if I cannot breathe and/or am going to pass out?

I am a big believer in 'mind over the matter', and would love to be able to deal with this in the simplest manner possible, if it is not life-threatening. Since I have been dealing with it for so long, I am wondering if that is indeed the case.

Thank you again for your time and effort!

Kind regards,
Answered by Dr. Rakhi Tayal 1 hour later
Thanks for writing again.

If it is just a bradycardia with a regular rhythm, then you can deal with it in your own way.

But intermittent syncopal attacks or dizziness might be due to complete heart block.

A simple ECG and ECHO will let you know if it is a heart block or not.

In case of heart block, if complete heart block occurs then death may occur. Cardiac pacemaker is the only treatment.

To overcome the dizzy spells, it is best to lie down straight on floor and raise your legs so that more and more blood can rush to your brain to maintain the consciousness.

Hope I have answered your query.
Wishing you an early recovery.
Above answer was peer-reviewed by
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