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Heart Disease (Expert Forum)
Slow Pulse Question
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Slow Pulse Question
by Squims, Jan 15, 2003 12:00AM
Doctor.
I’m a 29 year old male. My blood pressure is a good 128/74, and a recent ECG came back as 'tracing excellently’. For nearly two years my resting heartbeat has been consistent at around 55BPM, I have no associated symptoms.
It fell to this level at a very stressful time in my life when my father died (prior to this my pulse was around 61BPM). I’m always told that I should be pleased to have such a good, slow pulse but I can’t help being wary given that I’m by no means an athlete, and given the events going on in my life when things changed. I’d be grateful if you could address some questions that I have.
Is it possible that a stressful life event can improve the hearts’ function, as I’m being told it has?
I am extremely conscious of my heartbeat, and have occasional pauses. I’ve seen numerous posts questioning PVC’s and PAC’s, but these pauses most definitely are not following a quick beat. Would you regard these isolated pauses as unimportant in a heart that an ECG reports as being healthy?
Would you think that if something more sinister to be causing this it would have progressed and shown other symptoms during these two years?
My GP is totally convinced that anxiety is the source of my problems and once I get this under control these symptoms will disappear, and insists that further evaluation would be pointless (Being in the UK I’m not able to undergo any further testing without his referral). On the other hand I’d like your reassurance that I’m not trying to learn to live with something that I shouldn’t be.
Many Thanks
Squims
I’m a 29 year old male. My blood pressure is a good 128/74, and a recent ECG came back as 'tracing excellently’. For nearly two years my resting heartbeat has been consistent at around 55BPM, I have no associated symptoms.
It fell to this level at a very stressful time in my life when my father died (prior to this my pulse was around 61BPM). I’m always told that I should be pleased to have such a good, slow pulse but I can’t help being wary given that I’m by no means an athlete, and given the events going on in my life when things changed. I’d be grateful if you could address some questions that I have.
Is it possible that a stressful life event can improve the hearts’ function, as I’m being told it has?
I am extremely conscious of my heartbeat, and have occasional pauses. I’ve seen numerous posts questioning PVC’s and PAC’s, but these pauses most definitely are not following a quick beat. Would you regard these isolated pauses as unimportant in a heart that an ECG reports as being healthy?
Would you think that if something more sinister to be causing this it would have progressed and shown other symptoms during these two years?
My GP is totally convinced that anxiety is the source of my problems and once I get this under control these symptoms will disappear, and insists that further evaluation would be pointless (Being in the UK I’m not able to undergo any further testing without his referral). On the other hand I’d like your reassurance that I’m not trying to learn to live with something that I shouldn’t be.
Many Thanks
Squims
Doctor's Answer
by CCF-M.D.-RCJ, Jan 15, 2003 12:00AM
Squims,
Thanks for your questions.
I would like to make a few points prior to answering your specific questions. While it is possible that your pulse has actually slowed down since the death of your father, I am extremely skeptical about this point. It is much more likely that you have become more focused on your pulse rate since his passing, and thus now have perceived a difference that is not there. Further, young, otherwise healthy patients have a significant variation in their heartrate throughout the day. The difference in rate between 55 and 61 is rarely clinically significant, and is more likely due to the daily variation and not a statistically significant change.
Now to your questions...
(1) Anything is possible, but I have never encountered someone whom I felt derived an improvement in heart function from a stressful life event. However, I have encountered patients with broken-hearts after stressful life events...
(2) I can't comment on your pauses without knowing what they are. Fortunately it is very easy to diagnose their cause with a 24-hour holter monitor (a continuous ECG that you wear).
(3) Most disease have a typical timeline that does not vary, but this is not always the case. Cancers usually progress at a steady rate, for example, but Multiple Sclerosis and heart attacks are characterized by "punctuated events" with few or no symptoms in between.
(4) Anxiety is a frequent cause of preoccupation with one's heartrate and pulse. It is unfair of your GP to simply say "deal with it", but he/she is probably not being mean -- they may just not know what to do. I would recommend that you speak with him/her to formulate a plan that is suitable for both of you. The plan might include every 6 month follow-up, a holter monitor, and various treatment strategies for anxiety such as support groups, bio-feedback, yoga, or counseling.
Hope that helps.
Thanks for your questions.
I would like to make a few points prior to answering your specific questions. While it is possible that your pulse has actually slowed down since the death of your father, I am extremely skeptical about this point. It is much more likely that you have become more focused on your pulse rate since his passing, and thus now have perceived a difference that is not there. Further, young, otherwise healthy patients have a significant variation in their heartrate throughout the day. The difference in rate between 55 and 61 is rarely clinically significant, and is more likely due to the daily variation and not a statistically significant change.
Now to your questions...
(1) Anything is possible, but I have never encountered someone whom I felt derived an improvement in heart function from a stressful life event. However, I have encountered patients with broken-hearts after stressful life events...
(2) I can't comment on your pauses without knowing what they are. Fortunately it is very easy to diagnose their cause with a 24-hour holter monitor (a continuous ECG that you wear).
(3) Most disease have a typical timeline that does not vary, but this is not always the case. Cancers usually progress at a steady rate, for example, but Multiple Sclerosis and heart attacks are characterized by "punctuated events" with few or no symptoms in between.
(4) Anxiety is a frequent cause of preoccupation with one's heartrate and pulse. It is unfair of your GP to simply say "deal with it", but he/she is probably not being mean -- they may just not know what to do. I would recommend that you speak with him/her to formulate a plan that is suitable for both of you. The plan might include every 6 month follow-up, a holter monitor, and various treatment strategies for anxiety such as support groups, bio-feedback, yoga, or counseling.
Hope that helps.
Billy ***@****