Slow Heart Rate: What’s Bradycardia & Ways to Manage It

Have you ever found yourself halfway up a staircase, but your heart is still calm, like it’s meditating instead of helping you hustle? Or maybe when you check your fitness tracker, it’s just… ‘too chill’? When your pulse isn’t just taking a breather but consistently dragging slowly, it could point towards bradycardia. 

Now, this is not quite the same as skipping a heartbeat when you’re in love. If you have bradycardia, it means your heart’s rhythm is slower than it should be. This can be totally harmless, or it can mean that your body’s oxygen delivery system is signalling for a little boost. To help you understand any symptoms you might experience, let’s dig into what bradycardia really means, its causes, and when and how to address it. 

What does having bradycardia mean?

As mentioned above, bradycardia is a condition where the heart rate is slower than usual. While the typical resting heart rate for an adult juggles between 60 and 100 beats per minute (bpm), bradycardia lowers the heart rate to below 60 bpm. 

First things first, let’s clear the assumptions and the panic. A heart rate below 60 bpm isn’t always a red flag. Some people, who are extremely fit, like athletes, naturally have a slower heart rate. That’s just their body being efficient and supportive after years of hard work. So, when does it become alarming? If the slow heart rate is accompanied by other symptoms, which we will talk about below, or is caused by an underlying condition, that’s when you need to pay attention. 

Signs of bradycardia

Bradycardia is a discreet condition. You may not notice anything at first, especially if your body has adjusted to a slower rhythm. But here are a few signs you must look out for: 

• Feeling unusually fatigued, even and especially after a full night’s sleep
• Lightheadedness or feeling dizzy or faint
• Shortness of breath during casual everyday activities
• Chest discomfort (this can be subtle)
• Poor concentration or memory issues

Bradycardia symptoms: What to look for

Bradycardia symptoms can vary depending on how slow your heart rate is and how well your heart can pump blood. Here’s what people often report:

• Fatigue
• Dizziness or vertigo
• Fainting (also known as syncope)
• Shortness of breath
• Exercise intolerance (feeling wiped out quicker than usual)
• Confusion or memory issues
• Chest pain (in some cases)

What causes a low heart rate?

Several factors come into play when it comes to your heart's rhythm going off pace:

• Ageing: The heart's electrical system can wear down with age. 
• Heart tissue damage: Heart attacks in the past or any ongoing/underlying heart conditions may damage tissues and disrupt the rhythm.
• Congenital heart conditions: Some are simply born with electrical irregularities.
• Hypothyroidism: Low thyroid hormone levels can slow the heartbeat.
• Electrolyte imbalances: Particularly low potassium or calcium levels can disrupt heart rhythms.
• Sleep apnoea: Disrupts oxygen flow, altering heart rate over time.
• Inflammatory diseases: Conditions like myocarditis or lupus may impact heart signals.

Bradycardia vs tachycardia

You’ve probably heard of yin and yang, opposites that balance each other. In cardiology, bradycardia and tachycardia are the heart’s version of that concept.

Bradycardia is when the heart rate drops below 60 beats per minute (bpm), often caused by ageing, hypothyroidism, heart damage, or sleep apnoea. In contrast, tachycardia is a heart rate over 100 bpm, triggered by factors like fever, stress, anaemia, an overactive thyroid, or heart disease.

Bradycardia may cause fatigue, dizziness, or fainting, while tachycardia often leads to palpitations, chest pain, breathlessness, or anxiety. Both can be harmless or serious, depending on the cause.

Treatment for bradycardia

This is the tricky part because treatment for bradycardia really depends on the ‘why’. If your heart rate is low but you’re feeling great otherwise and have no symptoms whatsoever, you may not need treatment at all.

However, when symptoms start showing up or an underlying condition is identified, that’s when you need to seek medical attention and consider options. Treatment simply ensures the heart maintains a rate that’s effective at supplying the body with oxygenated blood, not more, not less.

Common strategies may include:

• Lifestyle adjustments like managing stress or addressing sleep apnoea
• Medical monitoring to track changes and progress 
• Addressing underlying causes, such as thyroid issues or any infections

Bradycardia treatments: Options & approaches

There’s no set list of steps or treatment that could work for all, but here are a few general approaches that are commonly considered as treatment for bradycardia. 

• Observation: Regular check-ins are common when your heart rate is unusually slow, but there are no visible symptoms or any underlying conditions causing it. 

• Managing contributing conditions: For example, treating a preexisting or underlying thyroid imbalance may resolve the issue with a slow heart rate as well.

• Medication adjustments: Sometimes you need to cross-check your existing medication, as medication meant to treat other conditions can affect the heart and slow it down. 

• Invasive procedures: In serious but rare cases, especially if one suffers from fainting or heart failure, a medical device might be considered to help maintain the heart’s rhythm.

Complications of bradycardia

While bradycardia is not always considered to be a serious condition, and some people live a perfectly normal life with it, untreated bradycardia can lead to complications. This happens especially if your organs are not getting enough oxygen due to the slow heart rate. 

Possible complications include:

• Frequent fainting spells, increasing the risk of injury, weakness, dehydration, and more
• Heart failure if the heart can’t meet the body’s needs and becomes too weak in the process 
• Sudden cardiac arrest in very rare and severe cases
• Cognitive decline due to reduced oxygen delivery to the brain

So if you’re experiencing symptoms, it’s important to seek medical expertise to catch it early instead of waiting for a warning sign that’s harder to ignore. 

Parting thoughts

Bradycardia or slow heart rate that is below 60 bpm, is not normal, but it’s not always a cause for panic. Still, you should never just brush it off, especially when it comes with symptoms or some underlying conditions that can cause bradycardia or make it worse. Bradycardia is harmless in most cases and can be managed, while in other cases, it might signal a deeper issue that needs attention. 

Listening to your body’s rhythm and recognising the signs can help you make the right choices at the right time. And whenever you’re in doubt, something, anything feels off, consult your doctor immediately. Because your heart might be slow right now, but you don’t have to be, especially when it comes to looking after it. 

Frequently Asked Questions 

1. What heart rate is too low?

Generally, a resting heart rate below 60 bpm is considered low, but it’s usually harmless unless symptoms are prevalent.

2. Is bradycardia reversible?

Depending on the cause, it can be. For instance, if the cause for bradycardia is low thyroid function or sleep apnoea, managing those can help reverse the condition.

3. Can stress or anxiety cause bradycardia?

It’s intriguing how, while stress typically raises heart rate, in very rare cases involving nervous system regulation, it might contribute to a slower rate as well.