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Bradycardia?

JimWoo50

Well Known Member
My hangar neighbor says he has pulse rate of 45 while resting and was diagnosed with Bradycardia. He is about 60yrs and average ht and wt. I have never heard of this and always thought a low pulse rate was good. I told him I would ask on VAF for more info as to how it would affect his flying. So if anyone has experience or info I?m sure he would appreciate it.
 
Not a doctor, but a paramedic so I do look at lots of EKG's. In and of itself that heart rate is fine if it is a regular sinus rhythm, and if it increases with exertion, which is probably what the AME will look for. If it is irregular, or there are other issues such as an AV block or bundle branch block then there may be concerns but even then the FAA guidance is fairly relaxed as long as there is no structural heart damage found.

Here is some FAA guidance:
https://www.faa.gov/about/office_or...app_process/exam_tech/item36/amd/arrhythmias/

I had a recent patient who broke his hip in a bicycle accident. He was 70 years old and said he rode 50 miles a day. His heart rate was 45 and he said that was high for him, probably due to the pain.

Chris
 
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If your heart rate is normally that low and you should ever need a pacemaker, be aware that it probably won't recognize that rate as normal and that could cause problems. It did for a friend of mine.

Dave
 
Low Resting Heart Rate

Endurance athletes regularly have resting heart rates in the 40's. I was a Cat-1 bike racer for many years and saw resting rate as low as 38 when I had good form. This did cause questions from doctors, but when I explained that I also had a VO2 max of 78 and a hematocrit in the high 40's (unassisted), they were generally satisfied :D
 
chris is pretty much right on. bradycardia describes a heartrate less than 60. just like tachycardia describes a rate greater than 100. sinus bradycardia is good, it defines the rate as being generated by the normal neuro path. more investigation is needed. sinus bradycardia is one thing,bradycardia can be quite another.
 
As others have said, bradycardia is of no concern if blood pressure and blood flow are normal - athletes have very efficient cardiovascular systems and do just fine with resting heart rates that are below "normal". Some medications (i.e. beta blockers for hypertension) lower resting heart rate as well.

In your friend's case, "bradycardia" is probably applied simply as a term that means heart rate is lower than the "normal" range (usually 60-100 BPM). It's a description rather than a diagnosis. Most physicians would ask the usual questions (exercise history, medications etc) and do nothing more (assuming EKG has been done) if there are no symptoms of concern. Typical symptoms I'd be asking about would be syncope (passing out), weakness/dizziness, postural symptoms - such as feeling dizzy or weak when suddenly standing up from sitting or lying position. If none of these are present and history makes sense (meds, exercise, or simply "it's always been low"), it's of little or no concern.
 
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As with what others said, it depends more on the reason for the rate rather than the rate itself. It may be physiologically normal with excellent conditioning or a sign of deeper pathology. In addition to an ECG, an echocardiogram would give information into hemodynamics.
 
Bradycardia

As a guy with bradycardia, as one gets older, and we all do, bradycardia gets to be more problematic and the reason is with a slow heart rate IF there is a problem, your heart rates being low starts reducing the options if a ‘problem’ happens. So my heart went from being described as ‘athletes heart’ to ‘bradycardia’ and when it got ‘too low’ (41 bpm) I got a pacemaker, and not given a choice in the matter. Two months later and some change I got my Class 1 medical back and that was 10 years ago and several trips around the world. No biggy ��
 
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Does anyone with Bradycardia have issues with drowsiness while at resting heart rate? I know someone who has had 2 car accidents but didn't realize he was falling asleep until after the accident - and then EKGs showed heart rate once in the low 40s and once right after the accident while strapped to a gurney still being around 70 (with all the excitement and shock should have been much higher)

So far he has not been diagnosed with any issue. EchoCardiogram complete, EEGs complete and no diagnosis (not even Bradycardia specifically).
 
Bradycardia will cause syncope which is preceded by dizziness and a lightheaded feeling. It will not cause drowsiness so to speak.
 
Bradycardia will cause syncope which is preceded by dizziness and a lightheaded feeling. It will not cause drowsiness so to speak.

Not disagreeing with this, but some syncope (fancy doctor name for fainting or passing out) - not all - can be caused by bradycardia, usually in what is known as a "Stokes Adams" attack which is much more than simple sinus bradycardia that's been discussed in this thread - it's due to a blockage in the heart's electrical conduction system. Occasionally, "vasovagal" syncope is caused by bradycardia and low blood pressure caused by excessive output from the vagal nerve - this is the cause of syncope from seeing blood or having blood drawn in some people but again, not related to the stable type of bradycardia discussed previously in this thread.

Uncomplicated, stable, sinus bradycardia usually DOES NOT cause syncope or drowsiness, or any other symptoms.
 
Not disagreeing with this, but some syncope (fancy doctor name for fainting or passing out) - not all - can be caused by bradycardia, usually in what is known as a "Stokes Adams" attack which is much more than simple sinus bradycardia that's been discussed in this thread - it's due to a blockage in the heart's electrical conduction system. Occasionally, "vasovagal" syncope is caused by bradycardia and low blood pressure caused by excessive output from the vagal nerve - this is the cause of syncope from seeing blood or having blood drawn in some people but again, not related to the stable type of bradycardia discussed previously in this thread.

Uncomplicated, stable, sinus bradycardia usually DOES NOT cause syncope or drowsiness, or any other symptoms.

Ya, my point is that when it is symptomatic it is syncope not drowsiness that one would experience typically. I had a patient once that was a long distance runner and who had a heart rate in the 40?s. Every once in a while while performing a vagal maneuver (sitting on the toilet) he would drop his heart rate a smidge too much.
 
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