Member Case Study: Resting Heart Rate is 45

author : AMSSM

comments : 2

Sinus bradycardia is defined as a heart rate less than 55 beats per minute. Bradycardia is commonly seen in well conditioned athletes, but other circumstances can cause a slow heart rate.

Member Question

My resting HR is 45. I am asymptomatic, but my wife (R.N. who works in a cardiac cath-lab) thinks I need to get the ticker checked out. I exercise regularly, but by no means consider myself an elite athlete. Are there any other weekend warriors out there who have similar resting HR's? I am sure that there are, but she has started me worrying a bit that I may have a problem.

Thanks.

P.S. It has dropped to ~37 while sleeping, and was recorded on a Holter monitor.

Answer

Sinus bradycardia is defined as a heart rate less than 55 beats per minute. Bradycardia is commonly seen in well conditioned athletes, but other circumstances can cause a slow heart rate. Some causes include medication side effects, metabolic disturbances, heart conduction abnormalities, coronary artery disease, certain infections, and even inheritance patterns.

Many individuals with bradycardia remain symptom free, but some concerning symptoms include light-headedness, passing out, shortness of breath at rest or with exercise, nausea and vomiting. Bradycardia during sleep is quite common, and rates can be as low as 30 beats per minute. Asymptomatic individuals with bradycardia generally do not require treatment, but physician evaluation is advised to rule out any causes mentioned above.

Luis E. Palacio, MD
Member AMSSM
Malden, MA

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date: December 18, 2006