Slow heart rate in a young person?

Some brief history first. I have a slow resting heart rate of about 35-50. It responds approiately with exercise or any type of activity. I'm 23 years old. I run 15 miles a week, and do weights 3 times a week. I had an echo, it was normal, and a holter two years ago showed an average rate of 60, I had one last month showed an average rate of 47. It showed some PAC's and PVC's, but not enough to be clinically significant. My EP I believe calls my condition sick sinus syndrome. He tells me that I may need a pacemaker someday. He says it could be 20, 30, 50 years or never. The problem is I worry it could be tommorow, a week, 3 years. I also have panic/anxiety disorder. My questions are.

1. I have read that a slow rate in an otherwise healthy young is a benign phenomoenon. My doctor seems to discount my exercise, saying I'm not an elite athlete. Based on your experience do you feel it is possible that this is a benign phenonmen that maybe many people my age have, but are unaware of it. I was never told to go see a doctor, I pursued the low pulse because of my anxiety issues.

2. I worry that my condition has deteriated since the last holter, since the average rate has slowed. Is this possible in a two year time period.

3. Given my above information, do you think it is as likely I may never need a pacemaker, as it is likely i may need one in a year.

Thanks very much, from a very scared and anxious person.

[CCF-M.D.-RCJ]

tkellyvt,

A slow heart rate in a young person who runs 15 miles per week, is asymptomatic, and has a normal echo is not something that should cause concern.  I think the drop in heart rate from 60 to 47 over the past two years is likely a sampling phenomenon; if you had 10 more holters, you would likely see that the average rates would be between those 2 numbers.

"You may be hit by a car on the way to school next week."

The above statement is about as likely as the chance that a young person with a heart rate average of 47 will need a pacemaker in the next 20 -30 years.

Furthermore, why are you concerned about having a pacemaker? They are placed during an outpatient procedure and are forgotten about by most patients once placed.  I'm not saying that the thought of having a pacemaker wouldn't provoke anxiety in most people, but the amount of angst you are experiencing is clearly out of proportion to the potential harm experienced by having a pacemaker.

For your own sake, pursue treatment for the anxiety and panic disorder.  Treatment for your heart can wait until something is actually amiss.

Hope that helps.

[Impotant1]

My girlfriend is 31 and has a BP of 90/60 and is tired all the time. The last time my BP was that low I died. If you have a slow heart rate I'd find a new doctor and find out why. Or like me you could start eating a lot of greasy food like chicken & ribs, start smoking a few packs a day and forget the exercise, maybe gain 50 xtra pounds & I'd bet you BP and heartrate would go up ! Good Luck & find a doctor that will take you serious.
It's your life.

[tkellyvt]

I have no idea what your comment meant, important 1. What do you mean last time your bp was that low you died. I never mentioned anything about low BP.

[dande4]

I'm questioning the difference in your resting heartrate from the monitoring you had done. Have you checked your rate at any other time? Is it usually that low or is it variable?. I'm curious to know if it just happened to be the day you took the last monitoring test if it just was a particularly low heartrate day for you. I know my pulse was 72 back in 1992, over the years it has been 99, 84, 68. I have a b/p machine that also calculates your heartrate. My resting pulse is not always the same.

Try not to worry too much about the tomorrows..

[NSINC]

Clearly your slow heart rate situation is very benign, and you have nothing to worry about.Impotent 1 ought to be ashame for provoking you towards more anxiety unnecessarily, and offering you the unhealthy advice about eating high cholesterol foods and smoking cigaretts merely to get your heart rate up.This is unbelievably silly.He`s got to be kidding.Please disregard his comments,and try not to worry too much.Many people will die (maybe not die)to have your medical situation.

[riveaux]

I think the root of a lot of arrhythmias and elevated blood pressure is anxiety which ultimately has its cause in fear - fear of tomorrow, fear of the unknown, fear of rejection, fear of conflict, etc. I agree that medication can help treat the symptoms in a lot of cases, oftentimes the true root cause is not addressed and is mental or emotional in origin, not physical. I have come to this opinion through my own experience.
I am a 50 year old male in excellent physical condition - I run, lift weights, swim, dirt bike, a bunch of stuff. I work as an engineer for a major oil company, I have made it through re-orgs, layoffs, buyouts, and the like since 1982. I have three teenage boys with the usual problems and college, car expenditures. My wife and I get along well - ups and downs like any couple.
Enough background. My PACs started 2 years ago after a swim workout. Stress tests, sonograms, Holter monitors confirmed that the heart was structurally sound, but the PACs happened after excercise for some reason. Holter showed that bradycardia (34 - 37 bpm happened thru majority of sleep). Blood pressure normal 130 / 70 w/ resting pulse 60 - 64 bpm.
Dr. prescribed Toprol, did not fully stop the PACs, but knocked me down in the dirt - low energy, low libido. Tried Tiazac, pulse down to 40 bpm, I felt like a marine mammal in the deep dive mode. Quit that. Dr prescribes Rhythmol - arrhythmia all the time now. Increase the dose and more PACs. Dr ready to prescribe something else and said "thanks" and haven't been back. I quit the Rhythmol, and things calmed down. Stopped the swimming workouts, stuck with running and lifting and PACs reduced even further. Complete blood work up done, found low testoterone. Started using gel testosterone, libido is back and PACs are way, way down. There is a link between my PACs and testosterone. I've also noticed that I somewhat control PACs by actively relaxing, not giving them "attention". I've also noticed that by getting pissed at fellow workers when they truly deserve it, instead of being "corporately" polite, will stop a PAC in mid flutter. I could hardly believe it myself the first time it happened. Anyhow, at this point I feel that I have made progress on minimizing the PACs without medication. I also feel that my PACs are strongly influenced by mindset and emotion.

[Impotant1]

Ahh yes I was kidding. But still wish I had his problem.
Still I would look for a different doctor who will take
you serious. My girlfriends doctor all but told her she was crazy and not to come back. Sometimes she gets dizy when it's to low.

[BillyboyAA]

I know exactly what you are going through.  I have a resting rate of about 45-50 usually.  It also responds with exercise.  I have had every test in the book and my doc just says I am in great shape.  If you would like to talk or anyone would like more info please email me...I also had a bad couple of years with panic/anxiety also......Please write me ...***@****

[pdh]

I used to have an average resting pulse of 48. Sometimes it would drop to 39. Also I have had BP as high as 220/120. The two aren't necessarily related. I went to the doctor because of feeling tired all the time and it was then when he found this BP level. My best mate has a BP of 90/60, av. pulse 85 and he is the most energetic person I know. We are both in our twenties, slim, eat healthily, non-smokers and excersize. Their are many different reasons why you may have high or low pulse or blood pressure. I admit stress and anxiety are the biggest causes of high levels but we are all different. Variations do not always mean there is a problem. But if you are worried, go and get checked over again. But to me 48bpm when relaxed seems entirely normal. I would be more worried if it didn't increase under strain.

[Kevlar]

Well, other than the comment " the last time my blood pressure was low, I died" (which by the way caused me untold joy for a few moments), I would say there are a lot of very healthy people commenting here.

If I may, I would like to ad my comment:

I have been a healthy athlete all my life, no problems of any kind. I am now 38 years old. 3 1/2 years ago, after 6 years at a very stressful job (being a middle manager is stressful period) and three shoulder surgeries (from 20 years of power lifting) AND two months of an Intense emotional loss that I need not dwell on here... I became severely depressed, had heart problems and anxiety problems. This literally happened in the blink of an eye one day at work.

For 2 years the doctors told me I was fine, just stressed. They wanted to give me anti-depressents. I took them for a three months and then got off PRONTO! I could tell they were not the answer for me. They made me less depressed and anxious for sure, they also made me less EVERYHING else too!

Long story shortened. I had a medically literate and up to date friend ask me to give testosterone a try. At first I thought he was crazy (I am 5'9" 210 and bench press 405 pounds; I have a seriously hairy chest and beard). But he convinced me and I had nothing to lose.

Within 30 minutes of applying a gel pack of testosterone (Androgel) ALL my symptoms were gone! I mean every last one and I felt the best I had ever felt in my whole life!

Things have leveled off a bit, it has been over a year, but I am convinced that there are a lot of problems that are hormonally mediated that science is just begining to figure out.

It has also been my experience that the absolute best general docs that will TRULY manage your case are the ones into "alternative" methods. Such as the Dr. Mercola Types and Dr. Ward Dean types... Having the traditionalist are great, they are usually very good at what they do, but for overall management, I'll take one that READS current literature and doesn't get all thier continuing education from the pharmaceutical reps selling them.

I know I sort of got off the subject and I don't have any real advice to offer other that what these others have offered. I just thought my story might encourage someone somewhere.

Don't give up, keep seeking the answers.

I especially like the advice given about not worrying about tomorrow... Didn't Jesus say something about that? :-)

Anyway, I appreciated reading this post string and congratulate all who have commented.