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Dr. Andrew Rynne

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What causes low heart rate and shortness of breath?

Answered by
Dr.
Dr. Saddiq Ulabidin

General & Family Physician

Practicing since :2011

Answered : 2525 Questions

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Posted on Sat, 7 Jan 2017 in Hypertension and Heart Disease
Question: Hi

I have had an issue for a year now and doctors aren't sure what it is. I get skipped beats with a low heart rate (48-58) at rest with 110-120 blood pressure. I get shortness of breath at rest not when exercising. I feel like I am going to faint after eating cold food. I also have bad reflux when I drink water which nexium doesn't fix. -any thoughts doctors?

I've have all the heart tests, blood tests, cameras, X-rays and ultra sounds to do with heart and stomach and all comes back good :(
doctor
Answered by Dr. Saddiq Ulabidin 5 hours later
Brief Answer:
May need holter monitoring and manometery

Detailed Answer:
Hi! Welcome to health care magic! Thanks for sharing your concerns with us. We will try to help you in best way possible.

First of all, it is sad to know what you had been experiencing lately. Based on the history you have shared, though low heart rate and blood pressure can be a normal variant in young or athletic individuals as heart doesn't have to do extra effort due to good functioning and thus less number of beats are sufficient however having symptoms like feeling faint and shortness of breath shouldn't be ignored with such pulse and specially history of missed beats. Initial tests like ECG and echo may turn out to be normal in such cases, but needs further evaluation on stress echo or ETT and if possible holter monitoring may be done which can detect any missed beats or abnormal rythm over whole day. I am sure if their is something relating to the heart it would be revealed on these.

The other issue relating to stomach appears to be gastroesophageal regurge disease or any issue with stomach opening. Endoscopy may turn out to be normal. You can discuss with your primary physician or a gastroenterologist regarding manometry to confirm that. Using motility agents like Domperidone or Itopride may help with the symptoms along with antacids like Omeperazole or Pantoprazole before meals as you have mentioned taking Nexium which alone may not be sufficient. Avoid heavy, greasy meals and junk foods or fizzy drinks.

Wishing you a speedy recovery. If you have any more questions, feel free to ask.
Regards.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Saddiq Ulabidin 9 hours later
Thank you for your reply. I have had an eTT with the doc saying they were all good. I have worn a hilter minitor a couple times with the tests saying they could see episodes however the SA node was fine they wernt worried aparently normal just some people can feel them and some cant.

I dont know if i am fit or not but i walk about 7-8 kilometers a day.
When i had the endoscopy they said the openings were the correct sizes. Are you saying even tho they are correct they still could not be working correctly? Could the stomach issue be cause the random flutters and skipped beats? The reason i ask is if i have a cold drink or ice cream i feel like fainting for a bit or ifi have alot of fries ill feel the occasional skipped beat.
doctor
Answered by Dr. Saddiq Ulabidin 12 hours later
Brief Answer:
It seems to be primarily due to stomach

Detailed Answer:
Hi! Thanks for sharing the details. If holter monitoring was alright then, hopefully it will not be related to SA node or heart primarily. And yes in conditions like gastroesophageal regurge or reflux, endoscopy finding may be normal. As far as, Both issues being inter related, is concerned, only possibility is being vasovagal as it can lead to missed beats as well as gastric motility issues. Only other possibility after cold drinks is that fizzy drinks tend to increase the regurge symptoms and that at trigger vasovagal response and should be avoided until motility issues aren't resolved. If problem persists, you can also consult electrophysiologist to consider for detailed electrophysiological studies. Hope this has answered your query, if you have any more questions, feel free to ask. Regards.
Above answer was peer-reviewed by : Dr. Yogesh D
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