Son is getting weaker everyday

[dlgerking]

My 25 year old son has been having a problem with his heart rate being too low for some time now, but over the last few weeks his heart rate has been getting lower on average 20-30 beats per minute and he doesn't have any energy.. he constantly feels dizzy or like passing out and when he does any type of exercise he fiants even just by walking...some days he can not even get out of bed due to feeling so weak..he is waiting to see a "Pacemaker" Specialist (that's what he was told) to see if he warrents a pacemaker...I guess my question is how long can he continue to have such a low pulse rate before it starts affecting his heart and other organs and can this problem lead to death?
Deb

[RockRose]

Glad he's doing better,  I'm kind of surprised the doctors didn't swing in to emergency mode quicker - that's a REALLY low heart rate!

Just kind of thought this link was interesting - the sinoatrial node (the "natural" pacemaker)

http://biology.about.com/library/organs/heart/blsinoatrialnode.htm

[mkh9]

Hi dlgerking,
Glad your son is doing better. It is good they told you what restrictions he has but it is too bad for someone so young. But, he will adjust and they may make him come in to check the pacemaker's speed now and then.
take care,
mkh9

[dlgerking]

we were informed that he will no longer be able to play sports or work out the way he liked to, he also has to be careful of high heat and severe cold..
he is doing much better now that the pacemaker has been put in, still gets a tired easily at this point but it has only been 15 days since he got the pacemaker, I am just glad they were able to get it  put in before any permandent damage was done to his heart muscle or other organs

[mkh9]

That is good that they were able to get the pacemaker in despite everything. I hope he does very well. I understand that they have the heart beat at a particular rate and that if you exert yourself beyond that the person with the pacemaker gets tired and may have other symptoms. Did they tell you that? I hope all goes well now.
mkh9

[dlgerking]

they did an echocardiogram, a 24 hour monitor and EKG...the echocardiogram did not show any abnormalities, the 24 hour monitor showed his heart rate decreased several times during the day and when he slept and the EKG was normal,,,,my nephew had the same tests run just a few months before his passing all with normal results (he had been feeling tired all the time and every now and then he felt like his arms were dead weight and he got dizzy spells........the same way my son started out)

[mkh9]

Did your son have the echocardiogram and 24 hour monitor done before this happened? You said he had a bunch of tests done that were negative. I don't know what else they can do to determine the electrical part of the heart is not working. They didn't find an arrhythmia?  
I wonder, they have an arrhythmia forum. I wonder if anyone on there could advise you more. They helped me a lot when I had my arrhythmia
mkh9

[mkh9]

I think you could have her get a echocardiogram (it checks for structural abnormalities) and a 24 hour monitor checks for the heart beat over the 24 hours and also can find arrhythmias. I had both done because of bad palpitations and found I have PAC's which happen to be benign. Also and EKG. They are screening or thinking of screening kids before they go into sports like football because there have been some deaths due to problems with their kids that they didn' t know about. I think that it is too much of a coincidense that two people in the family had similar problems at a young age. I don't know if the insurance would pay for it though if there is no sign of illness.
mkh9

[Gio77Italy]

I guess that is the state of the art of Medicine, there isn't much you can do about it. theoretically unexplained and potentially lethal conditions like that should be studied in Universities hospitals or something. theoretically.

[dlgerking]

he had all the tests run when they were trying to find out what was going on with his slowing heart rate, all of which came back ok...I asked the specialist if it was because he was premature (10 weeks early) and he assured me that had nothing to do with it, his heart muscle is very strong, of normal size and doesn't have any sign of disease, just his natural pace maker quit working....I also asked his specialist if could be hereditary since my nephew died at 21 years of age (he went to sleep and just never woke back up, upon autopsy they found nothing wrong with him his heart just stopped in the middle of the night) and the specialist said "that could just be a coincidence" this concerns me since I have a new grand daughter and don't know how to get her tested for congenital heart problems...so far all her doctors appointments have been good, but then again so were my son's, and her doctor doesn't seem concerned about her heart in any way

[mkh9]

There are lots of reasons Bradycardia can occur including a heart disorder present at birth. These congenital heart problems don't often show up until later. Other reasons can be hypothyroid, imbalance of eletrolytes (sodium, potassium, Chloride and CO2), Sleep apnea, etc. but the treament is the same, a pacemaker. I hope your son is doing much better now.
take care,
mkh9

[Gio77Italy]

congenital in the sense that it was genetic because he wasn't born with it but might have "timed out" at this stage of his growth.

Although I think it's more likely that the problem is acquired somehow. maybe it's related to that infection he had and even possibly the treatment he was given. as a matter of fact infections directly, or indirectly with autoimmune reactions, can disrupt the normal functioning of the Central nervous system.

diagnostic tools are very limited. MRI, blood tests for autoimmune diseases.

"This cardiac arrhythmia can be underlain by several causes, which are best divided into cardiac and noncardiac causes. Noncardiac causes are usually secondary, and can involve recreational 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."

" It is difficult and sometimes impossible to assign a mechanism to any particular bradycardia, but the underlying mechanism is not clinically relevant to treatment, which is the same in both cases of sick sinus syndrome: a permanent pacemaker." [Wiki]

you see it's not uncommon to have no medical explanation at all when bradycardia is "noncardiac"

how is he doing now?

[dlgerking]

what can cause a congenital defect and how can it be detected?

[mkh9]

Oh yeah, I reread the message and see what you mean regarding his "hatural pacemaker." That is good if the pacemaker they put in will work. Yes I haven't really heard much about this either although I have heard some 20 year olds die due to the family not knowing about their sons congenital heart defect and they were playing sports and it was too much for them. I think they are starting to do screens on the kids that want to play sports. Maybe they should screen all kids.
mkh9

[Gio77Italy]

@mkh9

actually his "natural pacemaker" was not working, with a artificial one he should be OK. I had never heard of anything like that before. Must be some defect, congenital or acquired, in the Autonomic Nervous System

[mkh9]

I'm so very sorry that you and your son are going through all this. I'm so glad he survived the pacemaker not working. I hope he is better now?
mkh9

[dlgerking]

Sorry I haven't posted until now....My son finally saw the specialist and was told that he had brachycardia and needed to get a pace maker...after a 3 week wait, my son finally got the pacemaker put in...by the time he went in to surgery his heart rate dropped to 9 beats per minute and his heart stopped 3 times before the procedure was finished (each time they were able to revive him thank God)....the specialist doesn't understand why his natural pace maker just quit working

[Gio77Italy]

it's always best to have the specialistic tests prescribed by the Specialist.
they'll also check his tyroid I guess.

I hope you can get an appointment soon, good luck.

[dlgerking]

His doc has never been concerned about his blood pressure since it has always that way...I also run low like that...the only illness he had before it all started was that infection in his foot (big toe to be exact) and had to put in the hospital because of the infection getting systemic, after all the antibiotics and treatments he was released with a clean bill of health the docs did all types of tests before saying he ok to leave...As for the echo being done his doc will not order it until he sees the Specialist he says he wants the Specialist to do it.

[Gio77Italy]

100/40 is unusual isn't it? there's a big gap between Systolic and Diastolic, maybe that low Diastolic can be indicative of something.

are you sure his symptoms were not preceded by anything unusual? even something apparently unrelated, headache, loose stool, UTI ?

does he have any other symptoms whatsoever? just dizziness and generalized weakness? there are some Autoimmune syndromes that give temporarily bradycardia but they are associated with paralysis of the limbs.

the infection in the foot might have started one in the myocardium ... ?

if he never gave you the results of the Echo. it was probably negative but you best have another one to be sure.

[dlgerking]

He has had a complete blood work up and everything came back alright..his pulse rate before getting sick was always around 60 bpm resting and at 130 bpm (the highest he could get it) during heavy workout he has always been active..his blood pressure has alway run on the lower side around 100/40.. he is 6'2" tall and weighs 210 lbs with very little fat..his pulse rate started dropping 3 months ago....he had a really bad infection in his foot 3 years ago but his doc doesn't think that has anything to do with it since he has been healthy until all this started..as far as the echocardiogram goes his doc never gave us the results of it and I have asked for another to be done but was told that he needs to see the Specialist before any more testing unless he gets much worse...Right now his pulse rate is staying at 27 bpm resting and non resting (they can't get it up with exercise which causes him to pass out)
deb

[mkh9]

I am sorry you are going through all this. I hope you see the specialist soon. I was wondering if they found any structural problems via the echocardiogram?  It sounds like a congenital problem but which problem needs to be found. keep us posted.
mkh9

[dlgerking]

he has had all the tests, and his doctor can't explain why his heart rate is so low, he is still waiting to see the Specialist...everything started with his pulse rate racing then falling, that went on for about 6 months, it went back to normal, then 3 months ago his pulse rate started dropping for no reason, no it is steadily getting lower, and he is getting weaker...Just don't know how long his heart and organs can go on like this before they are damaged
deb

[mkh9]

Yes that is a very low heart rate.  Has he had an EKG, 24 hour monitor and a echocardiogram (to check for structral problems)? If not I would have him get these done.  I don't know know what meds can increase the heart rate but I'm sure they have some for that to start with. It needs to be taken care of soon.