The normal rate of heart beats for humans is from 60 to 100 beats per minute. This is when the person is in a normal situation or at rest. The rate goes higher in conditions like exercising, stress etc. However, when the person is at rest and still gets the beat count less than 60, then it could be due to the condition of Bradycardia. This does not mean that it is an alarming situation whenever the count goes below 60, but it could be just a sign that something is not right with the electrical system related to the heart function.
- Sinus Bradycardia: The sinus node is the natural pacemaker for the heart. Its normal function is to generate the electrical signals for 60-100 times in a minute. When this node fails to function or gets delayed in generating the signals, then it is the condition of Sinus Bradycardia. This kind of Bradycardia is more prominent among children and athletes. It could be very slightly present that many times it goes unnoticed. Most of the causes that are listed below apply to this kind of bradycardia.
- Sick Sinus Syndrome: This category of bradycardia leads to the irregular or abnormal rhythm of the heart. When the person has irregular heart rates or when they feel a sudden rise and fall (or slow and fast) heart rates, they might be suffering from sick sinus syndrome. This category of bradycardia is not as prevalent as sinus bradycardia. People with existing heart diseases, or who have gone through heart surgeries are a bit susceptible to sick sinus syndrome since their sinus node might have got damaged or affected. Even though when people face usual wear and tear of heart tissues, it can lead to this disease.
- Heart block: The electrical signals in the heart need to flow to the chambers so that the oxygen-rich blood can flow properly. In case of heart block, the signals are not properly transferred among cells. In fact, the flow of the signal can completely stop in case of heart block. The medical term for this condition is Atrioventricular block. It depends on what degree it is present in. there is a mild degree or first degree which can cause no issues and is considered as closed to normal. Then, there is a third degree which is the most critical stage and is also referred to as “complete heart block”. In such a situation, the patient should be treated immediately. Generally, doctors don’t let the patients reach this stage provided patients take precautions and reports to the doctor timely. Though this disease can be by birth as well and it could also be caused by a heart attack. Other causes include inflammation of muscle in the heart, narrow arteries or coronary diseases and rheumatic fever. The rheumatic fever is very common in those children who don’t get proper treatment for strep throat.
Because of Bradycardia, the oxygen supply is not properly managed by the body, because of which some organs might not get enough of oxygen. Following are the symptoms of Bradycardia:
- Fainting: Lack of oxygen can cause people to faint or feel the near-faint feeling.
- Dizziness or light-headed feeling
- Shortness of breath: Even when the physical work is done is not much, people with Bradycardia experience shortness of breath. This can also be accompanied by pain in the chest in some cases.
- Misperceptions or difficulty in concentrating: The mind cannot focus well when the oxygen supply is not proper which leads to confusions and a non-alert mind.
- Loss of memory: People can face a hard time remembering things.
- Tiredness: Though some people get tired easily because of other reasons as well and one of the reasons could be Bradycardia.
- Ageing can cause heart tissues to damage which can lead to Bradycardia
- The heart tissues can also get damaged because of some current/past heart disease or even heart attack.
- It could also be by birth that the heart has this disorder.
- The tissues in the heart can catch some infection-causing disorders of this kind. This is also known as Myocarditis.
- If the person has gone through any heart surgery, then it might have left the heart vulnerable to Bradycardia.
- Thyroid glands which do not produce enough hormones can also be a cause. This condition is called hypothyroidism.
- Some chemicals like Calcium, potassium might not be present in the blood in balanced amounts, causing abnormal heart beat rates.
- Disturbances in breathing while sleeping over a long time.
- Fevers like rheumatic fevers or any such inflammatory condition can also cause Bradycardia.
- Any drugs which can have an impact on blood pressure, heart rhythm or used to treat psychosis can affect the heartbeat leading to Bradycardia.
All the above factors can have some impact on the electrical signals which are generated by the sinus node. The sinus node is basically a pacemaker (which is biologically present in the heart) and generates signals which in turn makes the heart to beat. So, if the sinus node acts slower than usual, or fails to perform its action, then it causes abnormal heartbeats.
Another cause of Bradycardia is the blockage of electrical signals in the pathway to and from the heart. To understand or visualise the meaning of ‘pathway’, it is important to understand how the heart works. The heart consists of four chambers which are divided into lower and upper ones. The upper ones are also known as atria. This is where the sinus node is situated. When this node generates the electrical signals, it causes the atria to contract which pumps the blood into the lower chambers of the heart. Those electric impulses reach the AV, which is the atrioventricular node. This further transfers the signal to some cells which in turn sends them to right and left ventricle. The right ventricle is responsible for sending blood which does not have much oxygen in it to the lungs and left ventricle is responsible for sending blood full of oxygen to the body. This is how the signals play a vital role in the body and those signals can be affected by multiple factors stated above.
Bradycardia can be a bit tricky to diagnose because the symptoms might not be present all the time. They could come and go. The testing used to diagnose Bradycardia is an electrocardiogram. This testing, also known by the name EKG, helps in measuring the electrical signals generated in the heart.
The symptoms might or might not appear while testing. If they do appear, then the diagnose because apparent, otherwise, the doctors need to observe and investigate more. For that purpose, they sometimes recommend wearing a monitor which monitors the heart beats for 24 hours. Other ways by which doctors diagnose is closely examining the symptoms in different situations and asking about the family history of the patient. It is important for the patient to be able to provide all the information to the doctor to avoid any misdiagnosis.
Prevention methods of Bradycardia are same as those of heart diseases. Take the necessary measures to avoid any kind of heart diseases. If you already have a heart disease of any kind, then you might need to monitor your heart beats during the day and even in the night. If there are any discrepancies found, you should consult the doctor immediately before Bradycardia takes over. Early detection can reduce the risk of having this disease. Following are the generic ways to keep your heart healthy and avoid any kind of heart diseases:
- Adopt a diet which has low sodium content in it.
- Maintain the body weight as per the BMI index. Being overweight is a very common reason for heart diseases. Keeping the weight under control will not ensure that you are safe from heart diseases, but greatly reduces the chances of catching them.
- Stay active- do some form of physical activity every day for at least 30 minutes.
- Quit smoking if you are a smoker.
- Avoid processed sugars at all costs. Things like cakes, chocolates, brownies, cookies, candies etc. should be avoided. These things can be replaced by natural sugars like fruits or dried fruits like figs etc.
- Eat lots of fruits and vegetables which aids a low-fat diet. Fruits are rich in vitamins and have good fibre which aids digestion and keeps the body hydrated.
- Keep an eye on cholesterol and sugar levels and keep them under control always. Differentiate between good and bad cholesterol and get yourself checked timely to notice any changes and progress in your controlled diet. The cholesterol levels can be maintained by eating nuts and avoiding fried food like fries etc. Junk food of all kinds mostly have a good amount of bad cholesterol and should certainly be avoided.
- Use of alcohol also needs to be monitored. If you must drink at all, the allowed dosage is one drink per day for women. It could be two drinks for men, but that applies to very healthy individuals and varies greatly from the condition of one individual to other. Based on your health condition, your doctor can advise the allowed limits of alcohol consumption.
- Taking drugs (recreational) is strictly not recommended, irrespective of how small their quantity is or how less often they are taken.
- Try to stay stress-free. Stress has a direct impact on heart and it also affects your gastrointestinal system.
Even while you practice all the above steps, going for regular check-ups and reporting any noticeable irregularities will be an ideal thing to do.
For people having a mechanical pacemaker, immediate consultation with the doctor is advisable since it could be the pacemaker which is not performing as expected.
Also, for people who already have any kind of heart disease, they should take their treatment plan very seriously and report to the doctor about any changes or unexpected events for further diagnoses. Neglecting the abnormalities by considering them a result of heart disease is not advisable.
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The treatment plan is only devised by the doctors after careful examination. They base their decision on the original cause of Bradycardia. Treating the cause or the ‘underlying condition’ can heal this disease. This is like eliminating the disease from its roots. Also note that if there are no symptoms found but heartbeat is at times lower than 60, then the doctor might not take any action at all, also depending upon the person’s health history. But for most cases, the doctors will advise you to keep an eye on the heart rates in case if changes drastically or needs attention later.
If there are any medications which are causing the heart to slow down, the doctor might reduce the dosage to see if that positively impacts the heart. Doctors can also use a pacemaker, which keeps the heart rate in control.
Below complications can be caused if the patient had symptoms of Bradycardia:
- Fainting quite often.
- Issues with heart when it tries to pump the required amount of blood- which can eventually lead to heart failures.
- Sudden heart attack or even demise.
Myth #1: It is often believed that if the heart rate is slow, it implies that the heart is weak. It is not always the case. There are certain reasons why people get this disease which is not related to the heart. For example, calcium content or disorders with Thyroid gland are also reasons for Bradycardia but they don’t imply a weak heart. When the heart tissues catch the infection, in those cases it can be said that heart is weak, but chances are that it is a temporary condition and can be fixed with the help of treatments.
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