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What Causes Slow Heart Rate While On Beta Blockers?

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Posted on Thu, 23 Jun 2016
Question: Ok, so I'm 5 days post partum...
I was discharged on Saturday with perfect vitals. My pulse was a tad low (60s) and I attributed it to my beta blocker which I took all through pregnancy for a HIGH heart rate. Blood pressures were perfect prior to discharge.
So now I'm home and my blood pressure is elevated (130s/high 80s) but my pulse is staying at 50-60! I've called my OB after hours, the cardiologist after hours, and no one seems concerned! This pulse is driving me crazy. I'm scared to sleep because I imagine it dips even lower and I'm scared to take my beta blocker in case that will lower it too. But my beta blocker should also lower BP (which it clearly isn't). Should I insist on being seen? I have no other symptoms (just sheer exhaustion and anxiety), but I'm scared I'm developing post partum eclampsia or something.
doctor
Answered by Dr. Lilit Baghdasaryan (4 hours later)
Brief Answer:
Nothing to worry, the dose of beta blocker may be decreased

Detailed Answer:
Dear Mrs,

If your slow heart rate bothers you, then there is a need to decrease the dose of beta blockers. Blood pressure of 130/80 mm Hg is not high. During and after the pregnancy there are hormonal changes that can lead to blood pressure variations, but as long as it is not higher than 140/90 there is no need for any medical intervention.
Don't worry.
You can write your beta blocker name and dose, I will try to help you. Or you can ask your physician.

Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Lilit Baghdasaryan (1 hour later)
Thanks for your response. I am taking Atenolol 25mg twice daily. Pre-pregnancy, I was down do only 12.5mg once daily, but as palpitations and heartrate increased from pregnancy, my dose was changed.
How long can I expect this low resting heart rate for? Also, while my dystolic has remained under 90, my systolic has gone as high as 144.
I am also taking Prozac for the anxiety, which Iassume the chest tightness could be attributed to.
doctor
Answered by Dr. Lilit Baghdasaryan (3 minutes later)
Brief Answer:
Welcome back

Detailed Answer:
Try to decrease the dose of Atenolol to 12.5mg, and monitor blood pressure and pulse for two days.
Come back in two days, if there are still some problems.

Wishing you good health
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Lilit Baghdasaryan (28 hours later)
My biggest concern with these readings is that im developing post partum preeclampsia and being dismissed from my doctors without even testing me for it. I have minor swelling in both feet and have developed a headache as of last night (not severe, just dull). Here are my BP/pulse readings from yesterday (on 12.5mg of Atenolol twice daily):
133/84 p58
134/86 p58
139/92 p56
141/88 p61

I am following up with my cardiologist this morning, but would she be able to test me for pre-e or will I have to ask my OB (again)?!
doctor
Answered by Dr. Lilit Baghdasaryan (2 hours later)
Brief Answer:
Welcome back

Detailed Answer:
Dear Mrs,
Your readings are not bad, they are borderline and nothing dongerous.
The only thing that we should pay attantion is edemas. For that I would advise you to have urinanalyse done and serum creatinine. If they are normal, then nothing to worry. I think your cardiologist can handle this and no need to see your ObGyn, unless there are some gynecological problems.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Lilit Baghdasaryan (47 hours later)
Thanks for the advice. I ended up going to the ER last night with a reading of 173/101. Upon arrival, it went down to 156/96. They did a urine analysis and complete blood work. All came back clean. My BP fluctuated while there, and when I left, it was at 133/91. Since my labs are clean, is this something that will just correct itself? Is this a common thing among post partum women? I think I'm going to take a break from checking it. Seems to cause more anxiety to know what it is .
doctor
Answered by Dr. Lilit Baghdasaryan (4 hours later)
Brief Answer:
Welcome back

Detailed Answer:
Hi,

If analyses came back normal, it is good. It means there is no complication.
Blood pressure fluctuations could be caused from
1. After childbirth there can be some anxiety from stress, which can cause blood pressure fluctuations
2. Hormonal changes during and after the pregnancy may cause blood pressure fluctuations as well.

You can wait for some time to see if it normalizes , if it decreases without any medication during an hour, then it is not dangerous.
If you have no complaints then don't take BP for couple of days. Or you can monitor it, but don't worry if you see elevated blood pressure during a week. If it lasts more than 10 days and blood pressure is more than 150/90, see your doctor and discuss the possibilities of treatment.

Take care
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Lilit Baghdasaryan

Cardiologist

Practicing since :2007

Answered : 1536 Questions

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What Causes Slow Heart Rate While On Beta Blockers?

Brief Answer: Nothing to worry, the dose of beta blocker may be decreased Detailed Answer: Dear Mrs, If your slow heart rate bothers you, then there is a need to decrease the dose of beta blockers. Blood pressure of 130/80 mm Hg is not high. During and after the pregnancy there are hormonal changes that can lead to blood pressure variations, but as long as it is not higher than 140/90 there is no need for any medical intervention. Don't worry. You can write your beta blocker name and dose, I will try to help you. Or you can ask your physician. Take care