By Richard P. Abben, M.D.
Director,
Arrhythmia Center
Cardiocascular Institute of the South

If you take beta or calcium channel blockers or digitalis for heart problems, watch for periods of unexplained dizziness or fatigue.

Occasionally, these medications cause bradycardia -- a heartbeat that is too slow.

Shortness of breath, lightheadedness, lack of energy and fainting are about the only symptoms of this condition. Unlike tachycardia, a too-fast heartbeat, there may be no feeling of heart palpitations with bradycardia -- no symptoms at all, in fact. Patients frequently blame their lack of energy on advancing years, sigh and do nothing about it.

A physician can easily spot bradycardia, if it happens to be present at the moment he checks the patient's pulse. However, it often comes and goes, and there are other things, like undetected infections, which can cause the same symptoms.

Medication-induced bradycardia can occur even in patients with no heart disease. Beta blockers are also used in the treatment of glaucoma.

Once medications are known to cause a too-slow heartbeat, treatment may amount to no more than adjusting or changing the medication.

But leave that to your doctor! Under no circumstances should you stop taking your heart medicine, or tamper with the dosage because you think it might be causing bradycardia. The symptoms are far too nonspecific for a layman -- or a physician, for that matter -- to diagnose without proper testing.

If your doctor suspects bradycardia, he may ask you to wear a Holter monitor -- a sort of portable EKG machine -- for 24 hours. If the heartbeat irregularity proves very elusive, you may be asked to wear a smaller monitor, called a cardiobeeper, that can record the heartbeat or transmit over phone lines when you feel the symptoms.

There are other forms of bradycardia, including those attributable to age-related decline in the bioelectrical system that makes the heart beat. A pacemaker may be needed to correct that form.

1995 Cardiocascular Institute of the South

For further information, call Jane Arnette, Cardiocascular Institute of the South/Houma, 1-800-425-2565, or Jim Keyser at 1-800-848-2715. E-mail questions or comments to: jakeyser@cardio.com.

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