First time poster here. I am 62 had an angioplasty following a heart attack last month, with a single stent being fitted. I was reasonably fit through walking beforehand, and have been enjoying daily walks since the procedure, gradually building up my range on the flat, so I am very pleased at what I can achieve in terms of exercise at this moment.
I don’t have my first cardio rehab appointment until next week, but I was wondering about my resting heart rate at present. The average pulse from my BP readings for this month is 57, and I was wondering if this would be considered low? When I took a blood oxygen reading earlier today, the pulse reading on that had gone down to 49, which made me a bit worried. When on a pretty brisk walk my pulse rate increases to 83/85.
I am on the medication shown below, and given that I did not have any history of high blood pressure prior to the cardiac event, I was wondering if it was necessary for me to be on the Bisoprolol, given the level of my resting pulse? Average BP for this month is 120/66. Apart from some low level headaches, which were present in the first week or two after the procedure but which now seem to have faded, and a bit of acid reflux, I’m not really experiencing any worrying symptoms.
I’m still on a learning curve at the moment, but if anyone has been in a similar situation and would like to share their thoughts I’d really appreciate it. I just want to know if my resting pulse rate is what is to be expected at present, or if it might be a cause for concern.
Meds:
Aspirin 75mg
Ticagrelor 90mg
Atorvastatin 80mg
Bisoprol Fumarate 1.25mg
Ramipril 2.5mg
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Bhunabhoy
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Your heart rate would be classed as normal and bordering on Bradycardia in the UK. Some doctors would say sub 60 is Bradycardia while most would put it at sub 50.Mine was 44 yesterday and probably lower when I went to sleep. It does not bother me. You can ask your GP to lower your bisoprol if you are concerned as your BP is on the low to normal band.
Hi my resting rate is 55 when im chilling infront of the tv , can go as low as 40 in my sleep and when i walking around 120 ,but thats of a fitbit so not 100%
Hi Bhunabhoy, my resting heart rate is around 42, sometimes lower late in the evening. ECG interpretation has said I have sinus rhythm bradycardia with ectopics. I have had a stroke and the search has been on for a cause and earlier this year an Afib event was detected. I was prescribed anticoagulants. In a phone consultation with the Cardiologist he discussed prescribing bisoprolol, sort of had a conversation with himself about the merits, and decided because of the Bradycardia not to prescribe for now because of concerns about lowering blood pressure at night. My BP is typically 100/59 .
I'm not aware of any palpitations or discomfort with my heart, they told me from remote monitoring of an implant device when I had the event and asked me what was happening then!
You will get case studies of one, as I have provided, and none of the circumstances will be the same as you.
Your HR is on the low side but over 50, and if you are relatively fit that may be an indication of that. But you would be on the cusp of a discussion about dosage etc and when you have another conversation with your Cardiologist or GP it merits asking the question.
Hi ramipril is given after heart attacks to protect from stroke,ticagelor and aspirin keeps blood thin so avoids clots,atorvastin is statin which protects organs, bisoprolol keeps blood pressure down and helps prevent heart attacks, you need to chat to cardiology and ask if can reduce any
From what I’ve read, those numbers look good. Low heart rate isn’t anything to worry about unless it’s not usual for you or if you have other symptoms.
Chat to your GP, but they’ll probably not be too concerned.
These are the standard meds everyone is given initially. I think it’s important to take what you need but to get rid of anything you don’t. I got rid of the beta blocker on discharge as my heart rate is usually in the low 50s resting and they dropped the bp one a few days later as it has always been low and went very low . We rang BHF nurses who told us to ring gp urgently and they were dropped. So now it’s just aspirin and statin.
That's amazing the cardioligy team seem to be trying to push more and more drugs on me despite being discharged back to gp and in good health with low everything before and after the attack!
I am 55 and suffered a heart attack nearly 11 weeks ago, and like you have followed a similar path. I am on exactly the same medication as you. I like you didn’t have high blood pressure before my HA.
My resting heart rate hoovers around the 50 mark and my blood pressure is even lower than yours. I am attending cardiac rehab each week where your resting heart rate is checked before during and after exercise and nobody is concerned. I think provided you feel okay then there is no need to worry. The medication just means that your heart will work slightly differently to how it did before.
Keep up the walking and getting yourself stronger, I managed to walk 4.5 miles at the weekend. 11 weeks ago I could bearly shower myself without being totally worn out. My cholesterol levels are also now normal (it was high and I did t know it) and my change in diet has meant I have lost a stone in weight.
my HR resting is mid 50’s but on 2.5mg Bisoprolol it was high 40’s - hadn’t paid too much attention to heart rate when taking blood pressure but then noticed - but I felt bloody awful - talked to GP and was reduced to 1.25mg - made a slight difference - while later post HA hospital took me off it completely due to HR too low - Personally I think it depends on how you feel - some people are fine with a low HR and I feel Ok with mid 50’s but not lower
The general practice at my GP is that once discharged from hospital I saw one of the nurses at the surgery for blood tests and blood pressure checks as the meds were tweaked in the early stages. It can be a frustrating journey especially when a heart issue/condition is unexpected. I've found to "listen to my body", use the BORG scale and stick to the medicine regime (I trust the research that has gone into it). I've only ever once asked for meds to be increased - after a third stay in hospital when one of consultants said I could ask for Monomil to be upped in response to more frequent spasms. And it helped the problem.
Hi, I’m in a similar position to you by the sounds of it. Had a big heart attack in 2018 and was put on the usual cocktail. My resting rate is low 40s but I feel very fit. Gp reduced my Bisoprolol to half a 1.25 per day due to my low heart rate. I’m no expert but I just think we’re all different and our drug dosages reflect that.
Sounds like you’re doing all the right things, good luck and all the best 😁.
My heart rate is usually lower than yours. It used to be on average 53 in the morning and 59 in the evening. I used to worry but then found out that atheletes have low rates and I am a gardener and cycle everywhere. No one is telling me its anything to worry about and I had a stent inserted in July so the cardiac team monitor these things a lot at the moment.
I found Bisoprolol lowered my HR at night and I did not like it, it went as low as 48/50. To me it what ‘you’re ‘ comfortable with. I started cutting the tablet in half but still it lowered my hr 🤷🏼♀️
Consultant changed my flecainide & Bisoprolol to Dronedarone and that dratted drug is doing the same, lowering hr at night and sometimes during sitting 🤷🏼♀️
I'm 71, my RHR is in the low to mid 50's (current 7 day average 56, 4 week average 53) although it has been down to 45. I can see a pulse rate, during the day, as low as 41. Doctors aren't concerned, I have reported it to them. One thing I was told by the Cardiac Rehab team was to not rely on a pulse oxi-meter for pulse readings as they can be inaccurate. Mine does seem pretty good though when compared to my heart rate monitor.
I'm also on Bisoprolol at the same dose as you, Ticagrelor 90mg twice daily along with aspirin, Losartan, Ezetimibe, Lansoprazole, Rosuvastatin and Felodipine.
I don't tolerate Ramipril or Atorvastatin. In fact, until my stay in hospital, I wasn't on statins to control cholesterol levels as I've had issues with Simvastatin as well and my GP had given up on them. Rosuvastatin is expensive and I understand it is reserved, primarily, for those with heart issues as a result.
My BP is a bit on the high side hence the Losartan and Felodipine.
All the meds you are on are pretty standard, the Ticagrelor is probably for 12 months only and is a blood thinner to prevent blood clots forming on the stent, mine is for that. Aspirin will be for life (at least mine is). I was also told that I'll probably be on Bisoprolol for life and possibly on an increased dose. We all differ individually so you may not be the same as anyone else. You'll find, possibly, that you bruise really easily, that's down to the Ticagrelor, I do and wonder where they come from!
Pulse rate is within the range that seems to be acceptable. I've taken up running to improve my fitness (doing 5k runs at present) since my PCI, AVR and CABG and I can get up to 130+ when exercising. Did that at rehab yesterday during my final assessment and whilst it was remarked on it wasnt flagged as an issue.
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Low resting heart rate.
Resting Heart Rate
Resting heart rate 
Daytime Resting Heart Rate Regularly Dipping to 42
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