My heart is beating too slowly - will it stop?

hi guys um my name is Sanjay Gupta I'm a consultant cardiologist and today I thought I'd do a quick video on the subject of slow heart rates and the reason I'm doing this video is because um quite often I come across posts um in various forums where people have written and said look I felt my heart last night and it was only going at 60 beats per minute and I'm now terrified because I'm worried it will stop when I go to sleep and I'll never wake up again and that causes a great deal of anxiety for people because they're worried about the fact that their heart rate is slow and I thought I'd try and clarify a few issues and try and um uh alleviate some concerns uh which may not necessarily be true okay so the first thing to say is um it is firstly really important to try and understand what the heart rate what the number means okay so you can feel your heart rate by feeling your pulse and the way we do it is we feel the pulse here in the radial artery okay so if you put your finger there you'll be able to feel the pulse and just count the number of times it beats over a 15 second period and multiplied by four and that will give you your heart rate but then what does that number mean say I say my heart rate is 70. how does that differ from my heart rate being 60. and it's crucial to try and understand what this means then what does this number mean and basically the idea is that the heart has a function the function is to try and get blood around the body and to supply the vital organs okay and it does so by beating at a certain rate because uh if it is pumping a certain volume out um around the body then it has to pump at a certain rate to try and keep that volume going around and um therefore the heart rate really is a surrogate for whether the blood is getting round okay um and that's what the heart rate means uh how fast is the blood getting round is the blood getting around now the normal heart rate um that uh um we consider within normal is anywhere between 40 to 100 well no it's anywhere between 60 to 100 beats per minute okay if your heart rate is below 60 then technically it would be called a low heart rate but that doesn't necessarily mean it's low for you okay because uh different people are different if you've um and I'll talk to you about causes of a low heart rate but say you feel your pulse and you feel your pulse to be 56 beats per minute okay before trying to work out what the cause of your slow heart rate is the first question that you have to ask is does it worry me to have the slow heart rate and the answer is that if all the blood is getting around then it doesn't really matter what your heart rate is it's still managing to do the job it's the blood is getting round how do you know the blood is getting around well if you can think clearly and if you can speak coherently then you can be confident that the blood is getting to your brain if you're warm to touch then you are you can be confident that the blood is getting to your skin if you are urinating normally then you can be confident that the blood is getting to your kidneys and if all those things are happening then please don't panic that your heart rate is so slow uh it's clearly doing the job you know you can still work out why the heart rate is slow but it doesn't really signify any danger whatsoever to you okay if I say to someone oh my heart rate is 30 um yes people will start panicking but if I'm there talking to them completely well it doesn't really matter now what are the symptoms if your heart rate is really too slow for you well if the heart rate is too slow for you then one of the first symptoms that people often complain of is dizziness because the heart is not beating enough blood to get blood all across the body and the furthest point where the blood has to go is the brain and therefore dizziness would be one of your first symptoms secondly tiredness thirdly um exercise intolerance so the heart rate is beating but it's beating slowly and actually when you need it to beat faster I.E when you exercise the heart is not able to beat faster because the heart rate is slow and therefore you will not be able to exercise as well and you'll get breathless or tired and therefore you'll have to limit how much you're able to do in the most extreme form the heart can be so slow that it can cause someone to black out if you are having those symptoms with a very slow heart rate and by that I mean usually less than 60 and often less than 40 then your heart rate is a problem and it needs to be rectified but other than that if you are not getting any symptoms please don't be worried about what your heart rate is then we have to ask ourselves well what are the possible causes of a slow heart rate and there are lots aging itself can cause the heart rate to slow down so as you get older you can uh your heart rate will slow down if you get fitter then your heart rate slows down um lots of other things happening in the body can tell the heart to slow down so it may not be a fault with the heart itself but if you have thyroid problems in particular if you are have an underactive thyroid or if you have any electrolyte problems with your potassium and your calcium that can be hard to slow down uh similarly hypothermia or jaundice can cause the heart to slow down then there are lots of medications that we take that can also cause the heart to slow down in particular things like beta blockers will cause the heart to slow down calcium channel blockers can cause the heart to slow down digoxin is another agent that can cause the heart to slow down ACE inhibitors can occasionally only in two percent of the population but ACE inhibitors can cause the heart to slow down but please don't worry about that it's worth getting investigated if your heart is below 60 beats per minute um but um it may not necessarily signify anything to worry about in a relative minority of patients particularly older patients the heart slowing down could signify a problem with the pacemaker that God gives us to keep our heart beating so if the pacemaker becomes prone to wear and tear with age and in that setting the heart can slow down and it can slow down to very slow rates to you know 20s or 30s similarly the pacemaker may be fine but the wiring system that transmits the impulses from the top of the heart to the bottom of the heart that can also become prone to wear and tear and that can also cause the impulses to slow down and when that happens you get something called atrioventricular block AV block if the pacemaker itself is problematic then that's called a sinus node problem okay the pacemaker is called the sinus node if that is faulty then you get sinus node problem if on the other hand it's the wiring that so the pacemaker itself is fine but the wiring is full see then that's an AV node problem or AV block all right so a lot of people say to me well what happens if that happens if you have a problem with your heart if you're saying if your pacemaker isn't working do you drop down dead and the answer is no almost uh that is incredibly rare even if you have a major pacemaker problem what tends to happen is the heart can slow down excessively the blood can go without uh sorry the brain can go without blood for a few seconds and when that happens the patient blacks out and that blackout could result in injury but often after the patient is blacked out they often regain Consciousness so the reason people put in pacemakers is not because they're worried that you will you know your heart will stop and you will never recover from it but it is more to do with the fact that your heart may slow down and for that period of time your brain would be without blood and you could black out and therefore you could sustain an injury and that is particularly relevant if you're Dr if you're someone who is a driver because that could happen when you're driving and that's why pacemakers are put in so um you know pacemakers are not pretend because you're worried that someone is going to drop down dead that's not why we put in Pacemakers in fact we know that from putting in pacemakers we know that pacemakers don't prolong life but they reduce the symptoms they take away the symptoms of black blackouts and collapses and dizziness it's also worth noting that in the very young patients you can get very very slow heart rates and that can be a completely normal physiological phenomena okay uh very young patients may get things called denki back block which is a type of Av block but that can be completely normal so in young people we don't tend to be too worried when we see very slow heart rates and but in older people we do tend to recommend pacemakers of course it's important to look into the patient's history and make sure that they don't have any other things that could be slowing the heart down but if despite removing anything that could be slowing the heart down correcting any abnormalities that could be slowing the hardware you still find that the patient is feeling dizzy or the heart rate is slowing down to the extent that they're getting symptoms then we would recommend a pacemaker in the elderly again if you have no symptoms of yeah of a shortage of blood you don't need a pacemaker all right um what else um could I tell you about this this is pretty well much it for the time being so um um so my message really is please don't worry about the number okay um even if the number is very low and you're getting symptoms don't worry nothing terrible is going to happen to you um there and then all you need to do is go and get it checked out all right it may be something very easy like some medication that you're taking or worse comes to worse it may require a pacemaker which is no big deal which takes about 20 minutes to do and we'll sort your problem out and that is only in the case of the patients who are quite elderly or who have a previous uh problem with their heart but in the young you certainly don't need any of that all right um so I hope this was useful I'll try and do some more videos again tomorrow uh but in the meanwhile I wish you all the best it's boxing day so I hope you've had fun and I'm going to just give you my Facebook page and my Twitter page and for those of you who want to contact me you can do so on www.yourcardiology.co.uk and there's a page which opens up which says you know um speak to me and you if you click on that then you can make an appointment to speak to me um and that's about it so thank you very much and all the best bye

Channel: York Cardiology

Views: 185,181

Keywords: #hangoutsonair, Hangouts On Air, #hoa, slow heart, pacemaker, blackouts, collapses, bradycardia, sanjay gupta, yorkcardiology, cardiologist, york

Id: cHYpLabRzcA

Length: 13min 20sec (800 seconds)

Published: Sat Dec 26 2015