Bradycardia

[Neeranam]

I have been feeling a bit strange recently. When going to bed, I have had a feeling of like pressure on my left chest side.

I went to the doctor and he said my pulse was very low. Not surprising as it has always been low.

He said if I was worried to take a EKG test, which I did.

My pulse rate was 32.

For the past 10 years or so it has been mid 40s.

When I was super fit it was around 36.

I have started smoking more these days.

He said that the pressure may be due to anxiety, and offered me Xanax I don't think it is anxiety, I have no reason to feel any. I do not want any benzodiazepines, that's for sure! Wouldn't anxiety make my heart rate go up?

Any heart specialists out there?

I am 39 years old.

Cheers

[johnh101]

I have started smoking more these days.

Maybe you answered yourself on this one.

It wouldn't be because you changed your avatar to a Heart with a green blob on it ??

[Neeranam]

QUOTE(Neeranam @ 2005-07-12 10:53:31)

I have started smoking more these days.

Maybe you answered yourself on this one.

It wouldn't be because you changed your avatar to a Heart with a green blob on it ??     

--------------------

Yeah maybe. I will try to stop today.

Never thought of my avatar, ha ha

[chownah]

Don't try to stop today....if you are not smoking a cigarette right now then you have stopped already and your efforts should be directed towards not lighting up another....if you are smoking a cigarette right now then put it out RIGHT NOW and then your efforst should be directed towards not lighting up another....

Try this mantra just before you light up your cigarette, "I want to destroy my health, I want to destroy my health, I want to destroy my health." If after saying this mantra you still light up a cigarette then use this time...with every puff think about how it will corrupt your lungs and shorten your life...think about how it actually makes you feel bad to smoke.....

[Neeranam]

Don't try to stop today....if you are not smoking a cigarette right now then you have stopped already and your efforts should be directed towards not lighting up another....if you are smoking a cigarette right now then put it out RIGHT NOW and then your efforst should be directed towards not lighting up another....

Try this mantra just before you light up your cigarette, "I want to destroy my health, I want to destroy my health, I want to destroy my health." If after saying this mantra you still light up a cigarette then use this time...with every puff think about how it will corrupt your lungs and shorten your life...think about how it actually makes you feel bad to smoke.....

Thanks for the tip.

[johnh101]

You know I think it is your body saying to you

"Ok you are 39 and have had a pretty wild, hard living existence, ups and downs, stresses and strains. If you want another 39 you better sort yourself out and fast"

Oh Sh1t, it's my body talking to me.......

[LoveDaBlues]

Go to a heart specialist. Now.

[Dradam]

I have been feeling a bit strange recently. When going to bed, I have had a feeling of like pressure on my left chest side.

I went to the doctor and he said my pulse was very low. Not surprising as it has always been low.

He said if I was worried to take a EKG test, which I did.

My pulse rate was 32.

For the past 10 years or so it has been mid 40s.

When I was super fit it was around 36.

I have started smoking more these days.

He said that the pressure may be due to anxiety, and offered me Xanax I don't think it is anxiety, I have no reason to feel any. I do not want any benzodiazepines, that's for sure! Wouldn't anxiety make my heart rate go up?

Any heart specialists out there?

I am 39 years old.

Cheers

<{POST_SNAPBACK}>

I am not a heart specialist. I would like to offer my 2 cents though.

In many cases, bradycardia is caused by damage to the heart's conduction system. In these cases, a pacemaker is sometimes required in order to bring the heart to a steady healthy rhythm.

While benzodiazepines (including xanax) are not strictly contraindicated for cases of bradycardia, it seems to me as if they would be used very cautiously as side effects include heart palpitations and bradycardia. Side effects also include depression and hallucinations as well so I myself would be hesitant to take them unless very necessary.

If you are not feeling any increased anxiety I would think it would not be prudent to prescribe an anti-anxiety medication for a heart condition such as this.

Perhaps you should find another medical opinion. Bangkok Hospital has an excellent cardiology department. You could check there. It would seem like your options would best include either a pacemaker or further changes in your lifestyle.

[zzdocxx]

I have been feeling a bit strange recently. When going to bed, I have had a feeling of like pressure on my left chest side.

I went to the doctor and he said my pulse was very low. Not surprising as it has always been low.

He said if I was worried to take a EKG test, which I did.

My pulse rate was 32.

For the past 10 years or so it has been mid 40s.

When I was super fit it was around 36.

I have started smoking more these days.

He said that the pressure may be due to anxiety, and offered me Xanax I don't think it is anxiety, I have no reason to feel any. I do not want any benzodiazepines, that's for sure! Wouldn't anxiety make my heart rate go up?

Any heart specialists out there?

I am 39 years old.

Cheers

<{POST_SNAPBACK}>

I am not a heart specialist. I would like to offer my 2 cents though.

In many cases, bradycardia is caused by damage to the heart's conduction system. In these cases, a pacemaker is sometimes required in order to bring the heart to a steady healthy rhythm.

While benzodiazepines (including xanax) are not strictly contraindicated for cases of bradycardia, it seems to me as if they would be used very cautiously as side effects include heart palpitations and bradycardia. Side effects also include depression and hallucinations as well so I myself would be hesitant to take them unless very necessary.

If you are not feeling any increased anxiety I would think it would not be prudent to prescribe an anti-anxiety medication for a heart condition such as this.

Perhaps you should find another medical opinion. Bangkok Hospital has an excellent cardiology department. You could check there. It would seem like your options would best include either a pacemaker or further changes in your lifestyle.

<{POST_SNAPBACK}>

I would ditto the above post--see a cardiologist and you may be a candidate for a pacemaker.

[Neeranam]

Thanks all for those replies.

I went to a heart specialist in Khon Kaen. I had to wait 4 hours to be seen but the price was good - 40 baht for everything, medication too.

He said that there is nothing wrong with my heart. great news. The problem is stress, and unhealthy lifestyle perhaps, which is still good news as I can change that.

NN

[Sheryl]

Thanks all for those replies.

I went to a heart specialist in Khon Kaen. I had to wait 4 hours to be seen but the price was good - 40 baht for everything, medication too.

He said that there is nothing wrong with my heart. great news. The problem is stress, and unhealthy lifestyle perhaps, which is still good news as I can change that.

NN

Don't want to bring you down, but I'm a nurse with more than 10 years coronary care experience and I have never seen a heart rate as low as you report in the absence of disease. Some people -- especialy athletes -- normally run in the low 50's, maybe drop as low as 46-50 during sleep. The definitiation of "sinus bradycardia"(i.e. a slow rate that is still operating under the heart's normal electricl conducting system) is a rate of 40 - 40. By definition, 32 can't be sinus bradycardia.

Furthermore, you reported some chest discomfort.

Anxiety and smoking tend to raise, not decrease, the heart rate. Certainly you should stop smokung, and since smoking does constrict the blood supply to the heart, it could explain your chest discomfort.

But unless you're sure you had a really complete work up -- the availability of which in Kon Khaen I doubt -- I still think it would be wise to go to Bangkok and get a complete exam. And if they don't find a cardiac cause, then see an internist to look for possible endocrine or neurologival explanation. A heart rate of 32 is just not normal, ever. Good luck

[Neeranam]

Don't want to bring you down, but I'm a nurse with more than 10 years coronary care experience and I have never seen a heart rate as low as you report in the absence of disease. Some people -- especialy athletes -- normally run in the low 50's, maybe drop as low as 46-50 during sleep. The definitiation of "sinus bradycardia"(i.e. a slow rate that is still operating under the heart's normal electricl conducting system) is a rate of 40 - 40. By definition, 32 can't be sinus bradycardia.

Furthermore, you reported some chest discomfort.

Anxiety and smoking tend to raise, not decrease, the heart rate. Certainly you should stop smokung, and since smoking does constrict the blood supply to the heart, it could explain your chest discomfort.

But unless you're sure you had a really complete work up -- the availability of which in Kon Khaen I doubt -- I still think it would be wise to go to Bangkok and get a complete exam. And if they don't find a cardiac cause, then see an internist to look for possible endocrine or neurologival explanation. A heart rate of 32 is just not normal, ever. Good luck

HI and thanks for the reply.

Actually, I might go down to bangkok for a check. I have found out that people who have recently come off benzodiazepines have had this experience. Some from a normal 80 down to 50 or so, which got back to normal eventually. My normal was about 45-50 I think, lower years ago when I was fit. I used to take propanalol when coming off benzos. I was on 200mg of valium for a few years and maybe 50mg for about 5 years, tapering off very slowly.

The definitiation of "sinus bradycardia"(i.e. a slow rate that is still operating under the heart's normal electricl conducting system) is a rate of 40 - 40. By definition, 32 can't be sinus bradycardia.

I don't understand what you mean. Please explain simply. When you saw a rate of 32, what were the causes.

NN

[Davey]

Thanks all for those replies.

I went to a heart specialist in Khon Kaen. I had to wait 4 hours to be seen but the price was good - 40 baht for everything, medication too.

He said that there is nothing wrong with my heart. great news. The problem is stress, and unhealthy lifestyle perhaps, which is still good news as I can change that.

NN

<{POST_SNAPBACK}>

Don't want to bring you down, but I'm a nurse with more than 10 years coronary care experience and I have never seen a heart rate as low as you report in the absence of disease. Some people -- especialy athletes -- normally run in the low 50's, maybe drop as low as 46-50 during sleep. The definitiation of "sinus bradycardia"(i.e. a slow rate that is still operating under the heart's normal electricl conducting system) is a rate of 40 - 40. By definition, 32 can't be sinus bradycardia.

Furthermore, you reported some chest discomfort.

Anxiety and smoking tend to raise, not decrease, the heart rate. Certainly you should stop smokung, and since smoking does constrict the blood supply to the heart, it could explain your chest discomfort.

But unless you're sure you had a really complete work up -- the availability of which in Kon Khaen I doubt -- I still think it would be wise to go to Bangkok and get a complete exam. And if they don't find a cardiac cause, then see an internist to look for possible endocrine or neurologival explanation. A heart rate of 32 is just not normal, ever. Good luck

<{POST_SNAPBACK}>

When your HR/pulse rate was taken, how was it taken? Over a period of 1 minute with a pulse rate of 32 is near your death bed, unless you are super-human fit. Some people take the pulse over a 15 or 30 second period and mutiply it by 4 and 2 respectively, perhaps you forgot to do so?

If it were stress, your heart rate would increase, and as Sheryl quite rightly pointed out, anxiety (of a form of distress) and smoking would increase your HR and smoking does constrict blood flow so that would explain your chest problems... Despite seeing your doctor in Khon Kaen I would definetly consult another doctor, in Bangkok would probably be the best option too.

Another thing, I hate to say that a doctor is wrong, but if you have a client come in with a HR of 32 and you simply say it is down to stress and unhealthy lifestyle, well this would increase your HR, there is no way these factors could contribute to a HR of a middle-aged man being so low. Please consult a professional doctor and best of luck

[Sheryl]

Don't want to bring you down, but I'm a nurse with more than 10 years coronary care experience and I have never seen a heart rate as low as you report in the absence of disease. Some people -- especialy athletes -- normally run in the low 50's, maybe drop as low as 46-50 during sleep. The definitiation of "sinus bradycardia"(i.e. a slow rate that is still operating under the heart's normal electricl conducting system) is a rate of 40 - 40. By definition, 32 can't be sinus bradycardia.

Furthermore, you reported some chest discomfort.

Anxiety and smoking tend to raise, not decrease, the heart rate. Certainly you should stop smokung, and since smoking does constrict the blood supply to the heart, it could explain your chest discomfort.

But unless you're sure you had a really complete work up -- the availability of which in Kon Khaen I doubt -- I still think it would be wise to go to Bangkok and get a complete exam. And if they don't find a cardiac cause, then see an internist to look for possible endocrine or neurologival explanation. A heart rate of 32 is just not normal, ever. Good luck

HI and thanks for the reply.

Actually, I might go down to bangkok for a check. I have found out that people who have recently come off benzodiazepines have had this experience. Some from a normal 80 down to 50 or so, which got back to normal eventually. My normal was about 45-50 I think, lower years ago when I was fit. I used to take propanalol when coming off benzos. I was on 200mg of valium for a few years and maybe 50mg for about 5 years, tapering off very slowly.

The definitiation of "sinus bradycardia"(i.e. a slow rate that is still operating under the heart's normal electricl conducting system) is a rate of 40 - 40. By definition, 32 can't be sinus bradycardia.

I don't understand what you mean. Please explain simply. When you saw a rate of 32, what were the causes.

NN

Rates below 40/min can result from cardiac disease, neurological disease, hypothyroidism, and also the effect of certain drugs -- particularly propoanolol and related agents.

It can also result from anything that seriously impairs the flow of oxygen to either the brain or the heart.

Get a full work up and be sure to provide detailed history of medications for the past 5 years. If you are still on propoanolol, then of course that's the answer right there, and see about getting of it. It is contraindicated in people with slow heart rates.

Good luck.

[Neeranam]

When your HR/pulse rate was taken, how was it taken? Over a period of 1 minute with a pulse rate of 32 is near your death bed, unless you are super-human fit. Some people take the pulse over a 15 or 30 second period and mutiply it by 4 and 2 respectively, perhaps you forgot to do so?

32 was the figure I got when taking my own pulse, and then the same as shown on the EKG readout. I check it over 6 seconds to get a rough idea, multiplying by 10, then 15sec X4 and 30secX2, this is usually accurate enough.

I haven't taken any propanalol since my check up.

My pulse yesterday was 40, and after jogging 92. It seems to be stabilised on mid 40's now. I am keeping it monitored and if it ever goes back down as low as 30-40 I will get a proper check up at maybe bangkok general, which I hear has a very good heart centre.

[Davey]

When your HR/pulse rate was taken, how was it taken? Over a period of 1 minute with a pulse rate of 32 is near your death bed, unless you are super-human fit. Some people take the pulse over a 15 or 30 second period and mutiply it by 4 and 2 respectively, perhaps you forgot to do so?

32 was the figure I got when taking my own pulse, and then the same as shown on the EKG readout. I check it over 6 seconds to get a rough idea, multiplying by 10, then 15sec X4 and 30secX2, this is usually accurate enough.

I haven't taken any propanalol since my check up.

My pulse yesterday was 40, and after jogging 92. It seems to be stabilised on mid 40's now. I am keeping it monitored and if it ever goes back down as low as 30-40 I will get a proper check up at maybe bangkok general, which I hear has a very good heart centre.

<{POST_SNAPBACK}>

I think that would be wise...

I still think mid 40's is a bit low (you must do a LOT of cardio to keep it so low) as long as you feel fine I suppose is the most important thing. Hope everything works out well.