Dear Christy,

I’m not exactly sure what the source of your son’s bradycardia is based on what you’ve written.  You don’t mention which medication he was on that was related to his low heart rate.  At any rate, I would need to have more information about your son to be able to say for sure whether his symptoms are related to bradycardia, which means getting more of a complete history.  In athletes who are in very good condition, a relatively low resting heart rate is quite commonly seen.  However, his dizziness suggests that his blood pressure may be low.  Therefore, before doing any further evaluation, I would make sure that he is adequately hydrated.  Teenagers often don’t drink enough fluid, skip meals, have a fair bit of caffeine intake, or combinations thereof.  And, symptoms are usually worse in adolescents probably due to growth and hormonal changes, but it also means that it usually goes away by adulthood.

So, how do we fix this?  I recommend that he have four 8-12 ounce glasses of fluid (water, juice, milk) per day as well as a salty snack (pretzels, saltines, pickles) in addition to everything he is eating and drinking.  Notice that I didn’t include chips—don’t want to give too much fat!  I also recommend that he not skip meals and that he eliminate caffeine intake (coffee, tea, soda, energy drinks), if he is doing either of these things.  Hopefully, this will fix his dizziness and nausea.  However, if he is still having problems despite these interventions, then it may be worthwhile for him to be evaluated by a cardiologist to assess his sinus node (the natural pacemaker of the heart) function as well as to look for evidence of autonomic nervous system dysfunction, or dysautonomia (as mentioned in the other post).  As well, it may be worthwhile to consider having him evaluated by an otolaryngologist (ENT) for vertigo.  Overall, if he is not getting better with this intervention, it will be very important for you to make sure that he is getting appropriate follow-up with your primary care provider to get to the bottom of things.

No he hasn't had any tests yet, he sees the cardiologist for the 1st time on June 1st. This has also been going on for 3 years.  The last 6 months he has gotten much worse.  He was first diagnosed with abdominal migraines by a gastroenterologist.  So he was referred to a neurologist.  He has tried practically every medication for migraines and nausea, none really help.  So he was prescribed anti anxiety medicine and told to see a psychologist.

The psychologist has been great.  She told us this is not anxiety and thinks it may be heart related.  She contacted his doctors and told them what she thought they should be looking for.  None of his other doctors were helping him anymore.  So now he has an appt with the cardiologist.  I fear they won't find anything, and I fear they will find something (catch 22).  

I will look into Dysautonomia.  Thanks for the suggestion.

Hi,
  Your son seems like he has some form of Dysautonomia-my duaghter has very similar symptoms and it took multiple doctors over a few years to determine her diagnosis. My daughter is going to see a cardiologist this Friday to hopefully help figure out some treatment options. Has he had a tilt table test (measures heart rate differences in different postions)? Good luck. My daughter was diagnosed by a diagnostician at Children's in Philadelphia.