Bradycardia - Symptoms, causes and treatment

Bradycardia is a condition when the heart beats slower than normal. Although it can happen to anyone, this condition is more prone to occur in the elderly, smokers, drug users, and people with stress or anxiety disorders.

A slowed heart rate is generally normal. The condition can occur in people who are sleeping, teenagers, or athletes. However, if accompanied by symptoms of dizziness or shortness of breath, a slowed heart rate can be a sign of a disturbance in the heart's electrical activity.

Bradycardia that causes symptoms is usually quite severe. In this condition, the heart cannot pump enough blood that is needed by the body. This can lead to decreased organ function due to not getting enough oxygen.

Causes of Bradycardia

The heart beats because of the work of the sinus node, which is a network in the atria of the heart that emits electrical signals with a regular rhythm. Electrical signals from the sinus node will be propagated to the atrium of the heart, then to the heart chambers and causes the heart to beat.

Bradycardia is caused by a disturbance in the flow of electricity to the heart. This disturbance can occur due to the following reasons:

  • Sinus node disorder

    Bradycardia can be caused by obstruction of the sinus node. Disturbances can occur if the flow of electricity that is generated becomes less, stops temporarily, fails to exit, or is blocked before successfully spreading throughout the atrial chambers of the heart.

  • The heart's electrical flow is blocked

    This condition causes the electrical current generated by the sinus node not to reach the heart chambers completely or not to reach the heart chambers at all.

The causes of these disorders can vary from person to person. Some of them are:

  • Damage to heart tissue due to aging
  • Heart attack
  • Congenital heart disease
  • Myocarditis
  • Sarcoidosis
  • Hypothyroidism
  • Electrolyte imbalance in the blood
  • stroke
  • Sleep apnea
  • Complications due to heart surgery
  • Consumption of drugs, such as beta blockers or beta blockers digoxin

There are also several factors that can increase the risk of this condition, including:

  • Seniors over 65 years old
  • Family history of bradycardia
  • High blood pressure
  • Excessive alcohol consumption
  • Smoking habit
  • Drug abuse
  • Stress or anxiety disorder
  • Have Lyme disease

Symptoms of Bradycardia

A normal heart rate can be different for each person. The following is a normal heart rate by age:

  • Adults: 60–100 times per minute
  • Children aged 1–12 years: 80–120 times per minute
  • Infants <1 year: 100–170 times per minute

In people with bradycardia, the heart rate is less than the lower limit of the above range.

To independently measure your heart rate, count your pulse at your wrist for 1 minute. In addition to the wrist, pulse can also be felt in the neck, groin, or legs. The examination should be carried out while at rest.

Apart from a slowed heart rate, bradycardia generally causes no other symptoms. However, if it occurs frequently or is accompanied by arrhythmias, a slow heart rate will cause disturbances to the organs and tissues of the body due to not getting enough blood supply.

When the blood supply to the organs and tissues of the body is disrupted, symptoms that will appear include:

  • Dizziness and weakness
  • Tired easily
  • pale skin
  • Faint
  • Hard to breathe
  • Chest pain
  • Pain in the jaw or arm
  • Stomach pain
  • Visual disturbance
  • Headache
  • Confusion
  • Cyanosis (bluish skin color)

When to go to the doctor

Consult a doctor if you frequently experience a heart rate that is slower than normal, or experience any of the above symptoms. Proper diagnosis and treatment must be carried out as early as possible, so that complications of bradycardia can be prevented.

If you have difficulty breathing, have chest pain for a few minutes, or have experienced fainting, seek immediate medical attention to the emergency department (ER) at the nearest hospital.

Diagnosis of Bradycardia

The doctor will ask about the symptoms that appear, the history of the disease and the consumption of drugs, as well as the history of the disease in the family. After that, the doctor will perform a physical examination, by measuring the patient's blood pressure and heart rate.

To confirm the diagnosis, the doctor will perform additional examinations, including:

  • Electrocardiography (ECG), to check the heart's electrical flow. However, the ECG can show normal results if at the time of examination the patient does not experience bradycardia.
  • Holter monitoring, to detect bradycardia that may occur at a later time. This tool can record the electrical activity of the heart continuously for 1-2 days.
  • Event recorder, to see the heart's electrical flow on the monitor on the device. Event recorder will record the electrical activity of the heart when symptoms appear. This tool is generally used for a few weeks to 1 month.

Bradycardia Treatment

Treatment of bradycardia should be tailored to the cause and severity of the condition. If this condition occurs without any symptoms, treatment may not be necessary.

If bradycardia is caused by a certain condition, such as hypothyroidism, your doctor will prescribe appropriate therapy to treat the condition. Meanwhile, in bradycardia caused by the use of drugs, the doctor will reduce the dose of the drug, change the type of drug, or stop the medication.

If the above measures do not show improvement or the patient's condition worsens, the doctor may recommend the use of a pacemaker. This small device will be implanted in the chest as a sender of electrical signals to the heart, so that the heartbeat can return to normal.

Complications of Bradycardia

Severe bradycardia and not getting proper treatment can lead to complications such as:

  • Frequent fainting
  • Hypotension
  • Hypertension
  • Heart failure
  • Sudden cardiac arrest

Bradycardia Prevention

Bradycardia can be prevented by avoiding factors that can increase the risk of developing this condition. The trick is to change your lifestyle to make it healthier, by doing the following simple steps:

  • Avoid smoking habits
  • Avoiding the use of NAPZA
  • Limiting alcohol consumption
  • Avoid stress
  • Maintain ideal body weight
  • Exercise regularly
  • Eat a balanced, low-salt diet

In addition to the methods above, check your blood pressure, cholesterol, and blood sugar levels regularly to the doctor.