How can a non-athlete have a resting pulse of 41

[brendannoyes]

Blood Pressure is fine (120/71).  Blood test are fine.  I am not athletic, in fact I am probaly 30 pounds overweight. I walk to my local train station and then to work, so maybe a walk of 1.5 miles one way a day. I am not dizzy.  Every once awhile maybe a tad tired, but nothing I ever complain about.  I went in for my physical and my nurse was converned that she found a pulse of 44.  The dr also voice his concerns after I told him I do not run or play basketball.

He told me to track my puls in the morning for 2 weeks when I wake up.  My avergae pulse was 44 with an occasional 40 and 41.  I even took my pulse at my desk in the afternoon after sitting for a few hours and it was always around 48, an occaional 50.  

I reported back to my dr. my 2 weeks of pulse numbers and now he wants me to get an EKG.  This seems like a waste of my money as everything I read on the internet says if you are not dizzy dont worry about your pulse.  If I am not symptomatic then what is the need for an EKG ?

[brendannoyes]

I got my echocardiogram results today and everything was normal.  I guess genetics has served me well when it comes to my efficient heart, but not so well when it comes to Math :)

Thanks for everyones input..it was very much appreciated.

[Mom2four85]

also make sure you ask for a copy of all of your test results and look them over and jot down any questions you have for your dr - sometimes they say "normal" when things actually show up on them

for example - my cardiologist did an echo; I had a Dilated left atrium and mild and trace regurgitation in all my valves; probably from aging since I'm in my 40's, and I had concentric LVH - which then they told me was normal but a month later they were concerned over this because my cardiac cath showed I had developed cardiomyopathy and my EF dropped from 55-60% down to 40%.

good lucky hopefully your dr will do a full cardiac work up just to be safe

[brendannoyes]

Thanks Ken...your response was explained well.  It made a lot of sense.  I will update next week.  

[kenkeith]

The heart pumps blood from the left atrium, through the mitral valve, into the left ventricle and out to the body. Any condition that increases pressure in this portion of the system can lead to an enlargement of the left atrium. These conditions may include hypertension, valve problems, atrial fibrillation or heart failure.

An EKG is only a tool that provides some evidence of a heart disorder...it requries further testing. There are false postives and false negatives with an EKG and an echo would be more decisive. An EKG is more reliable for a rhythm disorder, it is not very reliable for any structual abnormalities.  

Also, an echo can determine if you have an "athletic's" left ventricle and that is stronger than normal pumping and as a result the heart pumps more blood per heartbeat and requires fewer heartbeats at rest.

Hope this helps and if you have any further questions or comments you are welcome to respond.  Take care and keep us informated ot the echo results.

Ken  

[brendannoyes]

Ok..I had my ekg and now i'm somewhat confused:
The nurse called and said the tech ran two 10 second strips  or 5 second strips (not sure which it was) ..both said sinus bradycardia which I knew based on my low pulse, but the first strip also said left atrial enlargement.  They now want me to get an echocardiogram.  A few questions
Why didnt the tech just run a few more strips ?  If the rest of the strips did not show left atrial enlargement I assume my dr would not be requiring me to get an echocardiogram ?
Why not just run another EKG ?
If in fact I have a left atrial enlargement what does that mean ?

[brendannoyes]

Thanks for everyone's contribution..I will report back next week..

[erijon]

From Wiki;

"This cardiac arrhythmia can be underlain by several causes, which are best divided into cardiac and non-cardiac causes. Non-cardiac causes are usually secondary, and can involve drug use or abuse; metabolic or endocrine issues, especially in the thyroid; an electrolyte imbalance; neurologic factors; autonomic reflexes; situational factors such as prolonged bed rest; and autoimmunity. Cardiac causes include acute or chronic ischemic heart disease, vascular heart disease, valvular heart disease, or degenerative primary electrical disease. Ultimately, the causes act by three mechanisms: depressed automaticity of the heart, conduction block, or escape pacemakers and rhythms."

As you can see there are many causes, some serious which is why it's best to get checked out.

Jon

[Mom2four85]

i had no other symptoms than low HR's to begin with; it took many years for the functioning of my heart to become abnornal - a holter will show what exactly your heart is doing at different times of the day/night...ekg should be one of the things also in a full cardiac workup =)

[brendannoyes]

It seems to be the smart thing to do in get an EKG.  However, if I am not symptomatic (dizzy..tired) then wouldn't the rhythms be expected to be normal.

I guess my question is if I am not symptomatic and have no thyroid issues what are the potential issues the cardiologist look for when evaluating my case.

[Mom2four85]

they should do a 24 hr holter (or longer) to check things out and see what's going on; it may be nothing but do you want to chance that? I had no clue anything was wrong with my heart's electrical system but Bradycardia (low hr) a first symptom a doctor missed.

see a cardiologist just to be safe =)

[erijon]

40 is too low, only very well conditioned athletes should have a heart rate that low. You may be at risk for other rhythm issues. You should have a complete Cardiac and EP work up to determine if there is an underlying cause.

Good luck,

Jon

[brendannoyes]

note blood tests did not indicate any type of thryoid issue, etc.