You expect your body to slow down a bit as you age, but if the same slowing happens with your heart is that a good or a bad thing?
A low heart rate, called bradycardia, occurs frequently in older adults, cardiologist Jose Baez-Escudero, MD, says. It’s not always a problem, but it does require treatment in some cases.
“As people get older, there is occasional normal wear and tear on the electrical system of the heart,” he says. “As a result, the normal rhythm tends to slow down.”
If your heart rate is slow, but you don’t have symptoms, there’s no reason to worry. However, it’s a good idea to know the signs of trouble and consult your doctor if you notice any of those signs.
How slow is too slow?
Doctors consider a heart rate below 60 beats per minute as low, Dr. Baez-Escudero says.
If you have bradycardia, you’ll have a sustained heart rate below 60 even when you’re awake and active. A normal range is from 60 to 100 beats-per-minute while awake. The heart rate can also slow down normally while we are asleep to 40 to 60 beats a minute.
Is bradycardia dangerous?
For most young people, highly trained athletes, and people who exercise regularly, a below-60 heart rate is normal and healthy. It is very possible to have a slow heart rate and experience no symptoms.
However, if you have symptoms but ignore them, it can sometimes cause more serious problems.
Consult your doctor if you are experiencing some of these symptoms and you have an associated slow heart rate:
- Lack of energy.
- Low stamina.
- Chest pains.
- Confusion/memory problems.
- Heart palpitations or flutters.
If your heart rate drops into the 30s, you might not get enough oxygen to your brain, making fainting, lightheadedness, and shortness of breath possible. Blood can also pool in your heart chambers, causing congestive heart failure.
Why does bradycardia happen?
The most common cause for bradycardia is a malfunction in the heart’s natural pacemaker, the sinus node. It controls how quickly the top and bottom heart chambers pump blood through the body. Another cause is an atrioventricular block (AV Block), in which the top and bottom chambers don’t communicate well and the heart rate drops as a result.
“It’s like having virtual electrical cables and wires inside the heart,” Dr. Baez-Escudero says. “And, they deteriorate as we age. Common medications that are used in older populations can also often make bradycardia more significant.”
In fact, age is the most common risk factor for developing bradycardia. The condition is most common among men and women over age 65.
Illness or other conditions also may prompt it. These other causes include:
- Heart attacks due to coronary artery disease.
- Bacterial infection in the blood that attacks the heart.
- Inflammation of the heart muscle.
- Low thyroid function.
- An electrolyte imbalance.
- Too much potassium in the blood.
- Certain medications, including beta blockers and antiarrhythmics.
Congenital heart defects, diabetes or long-standing high blood pressure all may make bradycardia more likely, Dr. Baez-Escudero says.
How will your doctor find and treat bradycardia?
Your doctor will ask about your usual activities and conduct a physical exam.
He or she may use an electrocardiogram (EKG) to measure the electrical signals in your heart (to see whether they’re firing correctly). A wearable, 24-hour monitor can tell your doctor how your heart performs over time.
Once your doctor decides you need treatment, he or she will try to rule out medications or other pre-existing conditions as causes. Sometimes changing medications or similar strategies can solve the problem.
If not, implanting a pacemaker via minimally invasive surgery is the only option to speed up your heart rate, Dr. Baez-Escudero says.
He notes that bradycardia isn’t often an emergency, so doctors have time to choose the right treatment.
“In general, bradycardia allows time for us to evaluate the condition and rule out if any other condition is responsible,” he says. “Then, we can adjust medications or take other steps if we need to.”