Slight bradycardia.. strange symptoms

[dan_76]

I am 34 year old male. A bit overweight BMI 33.
It started a day after a long haul flight. My resting heart rate had been 75. But that day it was 50. I suffered from continuous missing-beat feelings also. Since then my heart rate has been fluctuating between 45 and 80.

I have issues with sleeping. I cannot get sleep because of strong heart beat. Secondly when I am about to fall asleep I flinch awake and my heart is beating strong. I feel some chest pain. It's more of a daggering feeling near where the heart is located and more continuous pressure type feeling which is not very strong. But strong enough not to go unnoticed.

I can exersice myself up to 100% heart rate without shortness of breath or other symptoms.

I have been through heart X-ray, ECG's, I have had Holter monitor for 24 hours, which all were normal, except the low heart rate of 49 day and 44 night. Stress test was good too. All blood tests came back fine.

I feel the symptoms like fatigue, dizziness, lightheadedness, nausea daily varying in strength. my subjective feeling is that these symptoms are more strong when my heart rate goes below 55.
My doctor has told me that all this is related to temporary sinus node dysfunction caused by probably some viral infection and that it should normalize over time.
1. Does the diagnonsis sound feasible? I feel it is little bit too easy and it gives me hard time to digest it fully.
2. Could the heart symptoms be secondary caused by some underlying disease? I have been considering something related to hormonal balance or lack or excess of some other substance.
3. Do my symptoms point to any serious heart condition even rare? I have been researching actively in the internet but haven't really found any fully suitable culprit.
4. Should I ask for echocardiogram as a next step? I really want to rule out all serious possibilities.
5. How normal are this kind of symptoms in general? It would help to hear that I am not the only one suffering from similiar problems.

[snarky348]

What kind of risk does a nuclear stress test have?  Does it expose you to a ton of radiation?  Is that it?

[CCF HeartMD-2]

Most likely what is happening is completely benign.  There are some rare conditions which could cause inflammation or infiltration of the heart muscle and or cardiac conduction system.  These include but are not limited to sarcoidosis and some rheumatic conditions.  Again, I would trust your physicians to put the whole picture together for you before rushing into many different and expensive tests, which are not without risk (nuclear imaging, etc) rather than going on a fishing expedition to find rare things.  An echocardiogram is a benign test and would be a nice start.  

[dan_76]

I am going to get the echo now. I didn't get it when I just saw GP in first place. Now that I went to cardiologist he referred me for it.

[snarky348]

PS -- The doctor is right, you should most definitely have an echo and I'm surprised you didn't!   Sorry, but what kind of quack are you seeing?   It's a cheap, easy, risk free test that provides tons of info...you should just see a cardiologist directly or ask for a referral to a clinic which handles a high volume of patients.

[snarky348]

Holy crap, I was just browsing today but I had to log in just to answer this guy.  This sounds so much like me.   I'm also a early/mid 30's male who's a bit overweight...   3 years ago I started having bradycardia in the 50's and sometimes 40's along with tons of extra beats every day.    I know they are telling you slight bradycardia is Okay, and they told me the same,  but I never had a history of that or the extra beats.   Also, at the same time, I started having a heavy uncomfortable pressure on my chest 24/7 (no one ever cared about that).   So, I went through this for the better part of 18 months,  and then suddenly my heart rate normalized,   I never saw it below the 60's anymore, and my extra beats went away 95%.   I went another 18 months or so symptom free,   but then I started having a more sustained fluttering episodes, this time lasting for up to a few minutes at a time ratther then just one quick beat or a few seconds of fluttering.   Only this time around, I'm not bradycardic nor do I have much chest discomfort.     Who knows.

[dan_76]

Thanks for the replies.

I have taken the exercise stress test and that was all fine. The echo is scheduled for next Friday. Although I do believe that my general symptoms are not heart related as my cardiologist has convinced me, it is better to be sure.

What my biggest worry is that if they're not heart related, what might be the cause. I have been wondering if the heart rate issue is just one symptom of some primary condition not yet identified. Thyroid should not be the one, since all the test have shown no malfunction there.

[CCF HeartMD-2]

I would make sure to have a sleep apnea study given your obesity and a thyroid function test. The reason your heart beat feels strong is because your heart pumps stronger each beat when your heart rate is low, so you may be more aware of the heart during the pumping.  There are rare infectious causes of low heart rates but these usually get better.  In the absence of any other clinical illnesses such as muscle disorders or other conditions, there should be no harm to you.  Also, the fact that your heart rate increases appropriately with exercise is a good sign.  
An echocardiogram can be done to rule out cardiomyopathy.

[CCF HeartMD-1]

Not sure about this diagnosis.  However, I think likely what you are experiencing is benign but I would want to make sure that you had an echocardiogram and that you got on a treadmill and that we documented that you got your heart rate up with exercise (sounds like you may have done this) without any abnormal heart rhythms (both fast or slow).  It is very normal as a 34 year old to have a heart rate that slow both during the day and at definitely at night especially if you are someone who exercises or is active whether now or in the past.  If an exercise stress test, a holter monitor and an echocardogram are all normal but you are still having slow heart rates and feel very poorly with this, then I would just make sure and refer you to an electrophysiologist (specialist within cardiology) to make sure that you don't have any abnormal conduction (the electrical circuit of your heart) which could be contributing.  

Hope this helps.  Good Luck!