Bradycardia and Stress Test

[calimassgal]

I am a 25 y/o female who was recently diagnosed with bradycardia at a routine doctor's visit.  I was diagnosed with symptomatic PVC's when I was 19 and have been on Atenolol 25mg daily since.  Several times, my doctor and tried to lower the dose as I was often fatigued, however, the PVC's would start up again and I was having fainting spells.  In October when my doctor referred me to the cardiologist, my resting heart rate was 36bpm.  She assumed it was because of the atenolol and again lowered my dose to 12.5 - I have fainted six times since lowering the dose, so we have gone back up to 25mg.  I had a tilt test, which I was told was normal, a holter, which I have not gotten the results back, echo (also normal) and a stress test.  Here's where my question is - My target heart rate during the stress test was 165 - I had made it to the fourth level, my heart rate got up to about 110 and then I started feeling short of breath and dizzy - my heart rate began to drop, to 100, 90 and down to 70 as I continued to walk.  The techs stopped the test at that point because of my dizziness and made me lay down.  It took quite a while too feel better again.  I will see the cardiologist on Monday and am curious what the prognosis is and what questions I should ask.  I am nervous that my heart seemed to do the opposite of what it was supposed to do during exercise. I often get dizzy and lightheaded while I exercise so typically only exercise very lightly to avoid those feelings.  What does it mean that my heart rate dropped during exercise and what can be done about it.  

Molly

[hapecamper]

I also forgot to add that sometimes my heart rate drops down to 40-50 bpm  then the palps start up. It just seems all over the place. Thanks

[hapecamper]

I have pvc's and pac's. I was given atenolol to try and I only tried it once, 12.5mg because my heart rate dropped to 40bpm. Not taking any meds now. I was just wondering if it's normal after walking for your heart rate to be at 140 bpm and your blood pressure to drop to 97/67? I've been taking my blood pressure after my walks and it is lower but about 2min after I take it again it goes to 130/80. All the test I took came back normal except for the heart palps which they say are nothing to worry about, But I get the palpitations really bad sometimes they also said I could try Lopressor if I wanted to but never tried it yet don't know if I will. Thanks.

[Cleveland Clinic]

Calimassgal,

Thanks for the post.

First you need to correlate whether your symptoms are due to bradycardia ie..occur specifically when your heart rate is low.
You have to remember if your cardiac evaluation is otherwise normal, PVCs while markedly annoying are benign.  If you are having problems with bradycardia, then you shouldnt be on a betablocker.

With respect to your exercise test, I would have to see the results personally. On a betablocker its not uncommon, especially for a young person to have a blunted response of heart rate and a fast recovery of heart rate once exercise intensity is decreased.

Other cardiovascular possibilities include a decreased blood pressure from the beta blocker, and POTS.

If you are not able to correlate your symptoms to blood pressure or heart rate changes, it may be worthwhile to seek evaluation of other causes with an internist or neurologist.

hope this is a start


good luck