Bradycardia – Diagnosis and Treatment
Diagnosis
Medical Exams and Heart Checks
A healthcare provider asks about the person’s health history and current symptoms. The provider listens to the heart with a stethoscope to check for a slow heartbeat or unusual sounds.
The provider might also ask if the person has fainted, felt dizzy, or has had shortness of breath.
Types of Tests to Check the Heart
Doctors use several tests and tools to confirm bradycardia and find out what might cause it. These include:
| Test Name | What It Checks |
|---|---|
| Blood Test | Finds infections, checks minerals (such as potassium), and looks at thyroid levels. |
| Electrocardiogram (ECG/EKG) | Tracks the electrical signals of the heart, looks for heart block, sinus node trouble. |
| Holter Monitor | Worn for 24+ hours to record heart activity during normal daily activities. |
| Event Recorder | Records heart readings only at certain times, used when symptoms pop up infrequently. |
| Tilt Table Test | Checks the heart’s reaction and blood pressure changes when moving from lying to standing. |
| Exercise or Stress Test | Observes the heart rate during physical activity or after certain medicines are given. |
| Sleep Study | Looks for breathing problems at night, such as obstructive sleep apnea. |
Blood Tests: Blood work checks for electrolyte imbalance, underactive thyroid (hypothyroidism), or infections like Lyme disease or myocarditis. Low or high levels can cause slow heart rates.
Electrocardiogram (ECG/EKG): This test spots sinus bradycardia, sinus node problems, and atrioventricular block. It records the heart’s electrical impulses with patches on the skin.
Holter Monitor: People wear this portable device for one or more days. It helps doctors find heart rhythm problems that might not appear during a regular visit.
Event Recorder: This device works like a Holter monitor but only records during certain moments. The person activates it after feeling symptoms.
Tilt Table Test: This test helps people who faint or feel dizzy. It checks how blood pressure and heart rate react when the table tilts.
Exercise Test: Some slow or irregular heartbeats only appear during physical activity. The test looks for heart rhythm changes, heart failure, or coronary artery disease triggered by exercise.
Sleep Study: If a doctor suspects sleep apnea affects the heartbeat, they order a sleep study overnight. The test checks for breathing pauses and their effects on heart rate.
Test results help doctors find out if the sinoatrial (sinus) node, atrioventricular node, or the heart’s electrical system has problems. This information guides the care plan or the need for more tests.
Treatment
Changing Medicine Plans
Some heart medications slow down the heartbeat. If this occurs, the care team lowers the dose or switches to a different prescription.
Patients should tell their healthcare provider about all medicines, including over-the-counter drugs. This helps the provider check if any medicine might cause bradycardia.
If another illness, such as thyroid problems or sleep apnea, causes bradycardia, treating that illness can help bring the heart rate back to normal.
Common steps include:
- Lowering the current medication dose
- Switching to another type of medicine
- Stopping a medicine that affects the heart rate
Surgical Devices and Other Options
When medicines and other treatments do not help, doctors may recommend a pacemaker. The care team places this small device just under the skin near the collarbone in a short surgery.
The pacemaker tracks the heartbeat and sends mild electrical signals if the heart beats too slowly. Doctors often use a permanent pacemaker when bradycardia causes serious symptoms and other treatments are not enough.
Table: Overview of Treatments
| Treatment Type | Example | Purpose |
|---|---|---|
| Medication change | Adjust dose | Manage side effects or switch medicines |
| Device implantation | Pacemaker | Correct persistent slow heart rates |
Getting Ready for Your Visit
Steps You Can Take Before Your Visit
Preparing for a heart appointment is important, especially for elderly patients or those aged 65 and older. Planning ahead helps you get the most from your visit.
Check for Any Instructions: Contact the office before your appointment to see if you must fast or stop certain medicines.
List Your Symptoms: Write down all symptoms, even if they seem unrelated, such as fatigue, chest pain, weakness, confusion, lightheadedness, or ongoing tiredness. Include if exercise makes symptoms worse.
Write Down Personal Health Details: Add any family history of high blood pressure, heart attack, angina, or thyroid problems. Note any recent changes or stress.
Record Your Medications: Make a table or list of everything you take (medicines, vitamins, supplements) with the dosages.
| Medication/Supplement | Dosage | Times per Day |
|---|---|---|
| Example: Atenolol | 25 mg | 2 |
Bring a Companion: Ask a family member or friend to come along to help remember medical advice.
Prepare Questions: Think of any questions about your symptoms, possible causes, needed tests, or if aging may affect your treatment.
Sample Questions to Consider:
- What could be causing my symptoms?
- Will I need blood work, such as for thyroid function?
- Do I need medicine or other treatments?
- Should I keep exercising or rest more?
- Are my other health problems (like high blood pressure) related?
- How often will follow-up visits be necessary?
What Your Doctor May Ask or Do
Doctors want to understand your condition clearly. They may ask questions such as:
- Have you passed out or felt dizzy?
- Do symptoms like chest pain or weakness get worse when you are active?
They might also ask:
- Do you have high blood pressure or receive treatment for heart-related illnesses?
- Are you experiencing angina or signs of a heart attack?
Other questions include:
- Have you noticed confusion or memory changes, especially if you are older?
- Do you smoke?
Your doctor may want to know:
- Are you taking any medicines or supplements that could slow your heart?
- Has anyone tested your thyroid function?
- Do you often feel tired or lack energy?
If you bring details about your symptoms and medical history, your doctor can better identify the cause of your slow heart rate. This helps them choose the right tests and next steps.
