What to know about a slow heart rate

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Zawn Villines    
by Gerhard Whitworth, RN
Symptoms | Measuring heart rate | Causes | Seeing a doctor | Treatments | Takeaway
A person’s heart rate generally slows with
age and while resting. However, athletes may also have slow heart rates. Anyone
with concerns about their heart rate should talk to a doctor for help in
determining whether bradycardia suggests a problem.
Heart rate changes with a person’s activity
level. During intense physical exertion, the heart has to pump faster and
harder, so the rate goes up.
In most adults, a slow heart rate is below 60
beats per minute (bpm). However, athletes and people who are asleep may have a
heart rate of below 60 bpm.
The primary symptom of bradycardia is a slow
heart rate. Some people have no other symptoms.
Other people do experience symptoms. In these
cases, a slow heart rate is more likely to be due to a serious issue.
Some common bradycardia symptoms include:

  • feelings of exhaustion and weakness
  • fainting or dizziness
  • confusion
  • shortness of breath
  • trouble breathing when working out
When a serious medical condition causes
bradycardia, and a person does not seek treatment, more severe symptoms may
Those include:

  • cardiac arrest, which means the heart stops
  • chest pain
  • low or high blood pressure
  • heart failure
heart rate
A person can find out their heart rate by
taking their pulse.
To accurately test for a slow heart rate, a
person must measure their resting heart rate. To achieve this, they must avoid
checking the pulse shortly after exercising or waking up.
To check the pulse, a person should sit in a
comfortable and relaxed position and feel for the pulse at the wrist. If unable
to locate the pulse at the wrist, they should try feeling for the pulse on the
side of their neck.
To work out their heart rate, the person
counts heartbeats for 10 seconds, then multiplies the number by six. For a more
accurate pulse, the person can count the number of beats for a full minute.
This figure is the resting pulse.
If the number is lower than 60, a person has
Children and young people have more rapid
heart rates than adults. In young people, normal heart rates are as follows:

  • Newborns: 100 to 180 bpm
  • Infants: 80 to 150 bpm
  • Children ages 2 – 6: 75 to 120 bpm
  • Children ages 6 – 12: 70 to 110 bpm
A slow heart rate in a child, especially a
newborn, is a medical emergency.
are the causes?
Some people have only moderate bradycardia.
Others only experience occasional bradycardia.
Although it is vital that anyone with a slow
heart rate seeks medical guidance, not everyone will require treatment. When
bradycardia causes no other symptoms, and when a person does not have an
underlying condition, a slow heart rate may be a harmless or minor issue.
The heart rate tends to decline with age,
which means older people may experience episodes of bradycardia. While this is
typical, it still warrants investigation by a doctor.
Exercise strengthens the heart. Athletes,
especially those who engage in intense cardiovascular activity, tend to have
more efficient hearts. This may slow their pulse because their heart does not
have to pump as hard or as fast to supply blood to the rest of their body.
Some medical conditions may also cause a slow
heart rate.
These include the following:

Problems with the heart’s natural pacemaker

The heart’s natural pacemaker, or sinoatrial
node, helps regulate heartbeat. Problems affecting this can cause a person’s
heart to beat unusually slow or fast, which doctors call tachycardia.
A condition that doctors call sick sinus
syndrome refers to problems with the natural pacemaker. Typically, another
heart health problem, such as scar tissue in the heart, complications of diabetes,
or coronary artery disease, causes these problems.
heart electrical issues
The heart communicates by sending electrical
signals. For example, one chamber of the heart sends electrical signals to
another, telling it how and when to squeeze blood into the next chamber.
The pacemaker helps regulate this electrical
system. If the heart is not able to send the correct electrical signals, due to
a blockage or heart disease, it can cause bradycardia.
Complete heart block is a type of electrical
issue that makes it impossible for electrical signals to travel from the atria
— the top two chambers of the heart — to the ventricles, which are the bottom
two chambers. In complete heart block, the top two chambers may have totally
different rhythms to the bottom two.
Some metabolic disorders can slow the heart
rate. One of the most common is hypothyroidism, in which the thyroid does not
produce enough thyroid hormones.
Hypothyroidism can affect the health of the
blood vessels, which may slow the heart rate. People with hypothyroidism may
also have a high diastolic blood pressure — a diastolic measurement identifies
the pressure in the arteries between heartbeats, and is the bottom number on a
blood test reading. A person has a high diastolic blood pressure if the test
shows a reading above 80.
Thyroid disorders are common and may affect
young and otherwise healthy people. Between 4 and 10 percent of people in the
United States have hypothyroidism.
Damage to the heart from congestive heart
failure, coronary artery disease, previous heart attacks, and other heart
problems may affect the heart’s electrical system, making the heart pump more
slowly and less effectively.
Some medications, including medications for
heart disease and high blood pressure, may lower heart rate. Beta-blockers,
which doctors prescribe for a rapid heart rate and some other heart conditions,
may also slow heart rate.
People taking a new medication who experience
symptoms of bradycardia should contact a doctor.
Doctors use the term hypoxia when the body
cannot get enough oxygen, which may slow down the heart rate.
Hypoxia is a medical emergency, and it can
occur when a person is choking or having a severe asthma attack. Chronic
medical conditions, such as chronic obstructive pulmonary disease, may also
cause hypoxia.
When hypoxia lowers the heart rate, it is
essential to treat the underlying cause.
to see a doctor
When a baby has a low pulse, a parent or
carer should take them to the emergency room.
Adults and children who have a low pulse and
experience severe symptoms, such as chest pain or fainting, should also go to
the hospital.
A person should see a doctor for bradycardia

  • they experience an unexplained change in
    heart rate that lasts for several days
  • they have bradycardia and other heart health
    risk factors, such as diabetes or smoking
  • they have heart disease and bradycardia
  • they experience bradycardia and other
    symptoms, such as fainting spells
  • they experience episodes of bradycardia and
A doctor may not always need to treat a slow
heart rate. However, when a slow heart rate causes serious health problems or
when heart disease slows the heart, it is essential that people receive
An artificial pacemaker, which is an
electrical device that a doctor inserts into the heart to promote regular
rhythms, can help.
Depending upon the cause, a doctor might also

  • changing heart medications
  • taking medication to treat thyroid or other
    metabolic disorders
  • making lifestyle changes, such as eating a
    low-fat diet, doing more exercise, or quitting smoking
  • monitoring heart rate or blood pressure
Heart disease is the leading cause of death
in the U.S., accounting for 1 out of every 4 deaths. It is crucial that a
person takes any changes in heart health, blood pressure, or pulse seriously.
However, a slow heart rate is not always a
reason for concern. In many cases, a slow heart rate is merely a variation of
normal. It may even be a sign of heart health and indicate good levels of
Only a doctor can evaluate an individual’s
cardiovascular risk factors. People should see a doctor for guidance and
Kayode Ojo
Kayode Emmanuel Ojo is the Co-Founder and Managing Director at SHEFFA Limited. He is presently studying Computer Science at the National Open University, Victoria Island, Lagos.