18 year old female borderline bradycardia ???

My 18 year old daughter had a routine annual physical a couple of weeks ago. She had discussed a couple of things with the doctor, one of which was the fact within the last month and a half she had a pain in the left side of her chest. And I mentioned that she seemed to be tired a lot. Since my daughter had just come home from college (freshman), the doctor said she was probably over tired from the rigorous schedule she had but told her she should stop staying up late about 2 weeks before she had to go back and get back on a regular schedule. She made mention that she 'normally' took afternoon naps between classes. But with her collegiate volleyball schedule we assumed that was just sleep catch up! The doctor did order an EKG to be done and it was completed that day and about 1/2 hour before the test she had another issue of pain. The next day we were told that my daughter's results showed 'borderline bradycardia...something' that her heart rate was 63 ...I do remember her blood pressure was like 73/106...or close to that. The nurse advised us that if she continues to have the chest pain they would set up a referral to a cardiologist. This is a bit scarey! She is an excellent athlete and other than broken or sprained bones or ligaments, she has not had issues! She can play volleyball for the entire matches/full game and never be pulled out....her season ended about mid November. I am just confused as to how serious or not this is since we are talking about the HEART!

[michellepetkus]

A cardiologist would be the best person to evaluate the health of your daughter's heart.  If she continues to have the chest pain I would definitely go back to have her evaluated.  Her bp likely 106/73 is good and her heart rate at 63 for an athlete is actually typical but the chest pain is something to get evaluated.  That said, in the absence of shortness of breath and dizziness she is likely OK but do keep on top of it just to be certain.  Take care and keep us posted on how she is doing.

[Jerry_NJ]

I agree with michelle, and note that I have never heard a resting HR of 63 described as bradicardia.  I don't have the number in mind (my age showing again) but I think the technical definition of bradycardia is a resting HR below 50.  

[is_something_wrong]

Sorry to say, but this is one of the most shocking posts I've read during 2011...

Answering this assuming there is no info here that we don't know..

What is wrong with her doctor? By what right does he scare young healthy girls with that nonsense? A resting heart rate of 63 is perfectly normal for young girls, and given the fact that she is exercising a lot, it's not low at all; young, well trained people often have a resting heart rate in the high 40s or low 50s, but who isn't slightly nervous when getting an EKG registered?

For example; my girlfriend does NOT exercise a lot. Her EKG read:

"Normal sinus rhythm, rate 55, normal intervals and waveforms. Normal EKG".

My 24 hour EKG registering read:

"Normal sinus rhythm, average 74, minimum 38 (during sleep) maximum 186 (when running after the bus..). Rare single PACs, otherwise normal. No significant tachycardia, bradycardia, arrhythmia or pauses".

Also, a blood pressure of 105/70 (no one can measure that accurate..) is not just good, it's exceptional. Excellent.

Regarding the chest pain; while all chest pain should be taken seriously and be investigated by a doctor, she is 18 and an athlete, and you are saying she can do heavy exercise for a long time without having chest pain. I think if an 18 year old athletic girl had coronary artery disease (angina, etc) she would almost be the first in the world. The only heart related condition I know about that may cause chest pain in young healthy girls is pericarditis (inflammation in the sac surrounding the heart) but that would usually show on EKG. The same would an inherited enlarged heart muscle.

Lots of conditions, most of them completely benign, can cause chest pain. Tense muscles is by far the most common, but acid reflux, a bruised rib, inflammations between the ribs, etc, are also common.

Maybe it's a good idea to see the cardiologist just to be sure (he can also rule out some lung conditions), but sorry to say, to me it seems that your doctor is making you both really afraid, and that is not good..

[grendslori]

Having raised a daughter who suffered and was dying from heart disease at 18, I can tell you that your daughter is probably 'good to go'; An 18 year old girl would not have coronary heart disease; it takes at least 20 years of eating junk foods to cause enough plague build-up in the arteries to cause chest pain. Also, her hormones would prevent her having CAD during her childbearing years as a protection during that time period; after menopause, that's a different story. As a EKG tech and supervisor, I can tell you that 63 is NOT considered Bradycardia. A normal heart rate is from 60-100 BPM. An atlete tends to have lower rates even down in the 40s range and for those individuals, that's considered normal, basically. Her blood pressure may be a bit low, yet even that would be acceptable with her sport activities. An EKG may still be normal in a patient with a know hypertrophic cardiomyopathy HCM), if it hasn't hit the point of severity to change the complex. An echo would still pick up the problem. I believe this is what something_is_wrong is referring to in mentioning 'inherited enlarged heart muscle', thaqt's what HCM is. If that was an issue, your daughter would have chest pain caused by a lack of blood flow to the heart muscle. The problem with that would be that your daughter would NEVER be able to handle sports activities; she would be way to sick at that point. Been there, done that, before my daughter's heart transplant. Chest pain involving the heart are also never on one side of the chest, that is usually muscle, cartiledge, ligament, maybe a lung issue. That's not heart related. Hope this helps. Take care

[momma_E2]

Thank you all for the words of sense....I actually told my daughter a couple of the things you mentioned before we went to see the doctor. I told her maybe she was having reflux like her older brother or she pulled a muscle or her 'boobs' were growing again. I was going to get a referral but then I realized no cardioligist is going to be able to see her before she goes back to campus. I have advised her to keep me posted on any other episodes but knowing how athletic she has been all her life-track in elementary school followed by gymnastics for 9 years now volleyball for the past 3 years, I just could not understand how she could have heart issues. I do understand that doctors are playing the game of 'liability' if they do not check all possibilities but geeezzz to scare us like this is unnerving! Thanks again. momma_E2

[momma_E2]

Thank you all for the words of sense....I actually told my daughter a couple of the things you mentioned before we went to see the doctor. I told her maybe she was having reflux like her older brother or she pulled a muscle or her 'boobs' were growing again. I was going to get a referral but then I realized no cardioligist is going to be able to see her before she goes back to campus. I have advised her to keep me posted on any other episodes but knowing how athletic she has been all her life-track in elementary school followed by gymnastics for 9 years now volleyball for the past 3 years, I just could not understand how she could have heart issues. I do understand that doctors are playing the game of 'liability' if they do not check all possibilities but geeezzz to scare us like this is unnerving! Thanks again. momma_E2