Getting older is inevitable.

With age comes a new aspect of life that, until now, you may have put off thinking about. There are benefits like getting a senior discount at your local pharmacy, and being given priority parking.

There are also things that are less ideal. Our bodies age. This means we are more prone to developing medical conditions.

Getting to know problem areas like your heart is an excellent way to be prepared if something were to go wrong. It is worth knowing what to expect of an aging heart and signs to look out for.

Bradycardia is one cardiac condition to be aware of. Let’s take a look at what it is and at what point you need to be concerned.

What is the Definition of Bradycardia? 

Bradycardia, which simply means a slow heart rate, is a common side effect of aging that is often overlooked. There is a lot of information regarding irregular heart rhythms and faster than average heart rate (“Tachycardia”), but not as much for bradycardia.  A normal healthy heartbeat for an adult at rest is generally between 60-80 beats per minute (BPM). Heart rates below 60 BPM are consistent with bradycardia.  We can measure our heart rate by counting our pulse for a minute, or to save time count your pulse for 15 seconds and then multiply the number by four.  Other ways to measure your pulse rate include an automatic blood pressure cuff (which will report the heart rate along with the blood pressure) or an inexpensive gadget known as a pulse oximeter that you can buy for less than $20 online.

While a lot of people experience bradycardia, it is not always abnormal, and not all people with slow heart rates will have symptoms. Bradycardia only becomes serious when the heart isn’t pumping enough oxygen-rich blood to meet your body’s needs.

How Is the Heart Rhythm Controlled?

The heart rhythm is controlled by the heart’s electrical system. All rhythm problems arise from abnormal functioning of the electrical structures within the heart. Each normal heartbeat is generated by a structure called the Sinus Node. The sinus node is located at the top of the right atrium. It “fires” or generates an electrical signal that starts each normal heartbeat. That electrical signal spreads across the top chambers and stimulates the atria to contract. The electrical signal then passes through the electrical connection between the top and bottom chambers. This connection is called the AV (atrioventricular) Node. The AV node allows the top and bottom chambers to work together and maintains efficient pumping of the blood.

Bradycardia can arise from problems within the sinus node that cause it to fire more slowly than normal.  This is known as “Sinus Bradycardia” and can be diagnosed if the heart rate is less than 60 beats per minute. Bradycardia can also occur if the AV node does not pass all of the signals down from the atria to the ventricles. Either condition can reduce the pulse rate.

Keep in mind that the heart is a “team player,” and the sinus node responds to signals it receives from the brain. Your brain is continuously adjusting your heart rate to match your body’s needs, and someone with a very strong heart who may be very fit and physically well-conditioned may run a slow heart beat normally. It’s not uncommon for athletes to have sinus bradycardia with resting pulse rates in the 50s or even in the 40s. Although that is still considered “bradycardia,” it is not abnormal for them because their heart is meeting their body’s needs very nicely.

What are the Main Causes of Bradycardia?

Let’s take a look at the leading causes of Bradycardia.

1. Bradycardia Caused by Aging of the Heart

One of the natural side effects of an aging body and heart is bradycardia. Generally, aging of the sinus node occurs very slowly, so we actually expect the “normal” heart rate to be a little slower in older people.  Problems arise when the heart pumps too slowly and has a hard time providing oxygen and nutrients to all the organs of the body, which can cause symptoms of weakness, fatigue, lightheadedness, shortness of breath, and inability to exercise.

With aging of the heart, AV node problems can also occur. When the electrical signal has a hard time getting through this structure, patients will develop “AV Block,” which reduces the pulse rate and can cause severe symptoms of lightheadedness, fatigue, and even fainting.

Other age-related diseases can contribute to bradycardia. These include coronary disease, valvular heart disease, and myocarditis. You are also more likely to experience bradycardia if you have previously suffered a heart attack.

2. Bradycardia Caused by Other Issues in the Body

The body is interconnected in many ways, and sometimes existing medical conditions can contribute to a slow heart rate.  These include issues with your thyroid gland or your adrenal glands that result in low hormone levels. Many medications used to treat conditions such as high blood pressure, coronary blockages, heart arrhythmias, headaches, and even certain eyedrops used to treat glaucoma can have a side effect of bradycardia.  One rare cause of bradycardia due to AV block in relatively young patients is Lyme disease, an infection that is transmitted by the bite of a very small insect known as the deer tick.

How Does One Deal With Bradycardia?

We have taken a look at what causes sinus bradycardia. In someone who is well conditioned and runs a slow heart rate, there is nothing to worry about.  You must be doing something right!

Normal people who run a slow heart rate but who otherwise feel well should not limit their activities. In fact, exercise can improve their body’s ability to deal with bradycardia. Exercise conditions your muscles to become more efficient at extracting the oxygen from your blood, so you can function normally even in the face of a slow heart rate. Exercise also increases your heart muscle mass, making your heart stronger so it can beat more effectively. That can make up for a relatively slow heart rate.

Some effective, safe exercise regimens include:

  • Walking:  This is an excellent, low-impact way to improve the fitness of your heart. Start slowly on level ground, and start with 10-15 minutes a day. Gradually increase the speed and duration until you are able to walk briskly for at least 30 minutes each day.
  • Water Exercise: exercise in the water, like aqua aerobics, swimming or jogging in a pool, are great alternatives to “high impact” activities. As you age, your joints become weaker, and you will find you cannot put as much stress on them as you used to. The buoyancy that the water provides allows you to exercise more vigorously without stressing your knees and hips.
  • Bicycling: Bicycling is a great exercise to increase the strength of your heart. It’s easier on the knees and hips than walking or running, and you can use an indoor stationary bike on bad weather days.

By starting out slowly, you can gradually improve your fitness. The more you increase your level of fitness, the stronger your heart will become. This will help to avoid the symptoms of bradycardia.

What If Symptoms of Bradycardia Occur?

Bradycardia can progress to the point where the heart is just not able to pump sufficiently to get the oxygen where it needs to go. If there is a reversible cause of bradycardia, such as an underactive thyroid gland, or if you are taking a medication that might be slowing your heart rate, the problem may be solved by changing your medications or treating the underlying condition.

However, if there is no reversible cause of bradycardia and you are suffering from symptoms like fatigue, exercise intolerance, lightheadedness, shortness of breath, or other signs of inadequate blood flow, then the best solution is a permanent pacemaker. Pacemakers are small, battery-operated devices that are surgically implanted under the skin and are designed to restore a normal heart rate. These will relieve the symptoms of bradycardia and allow you to return to a more normal lifestyle.

For a lot of people, bradycardia does not manifest itself beyond a slower than normal heart rate. However, it is wise to consult your physician and seek their advice if you are experiencing any symptoms as described above. Bradycardia can be harmless, but it can also be serious in some cases.

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