heart rate

[gasp1]

can anyone advise I have had 3 episode this evening of my iwatch telling me my resting heart rate at dropped to 48 bpm for longer than 10 mins my watch is normally spot on re heart rate is this too low I am on various heart meds due to micro vascular angina

[Tos92]

Hi gasp1,

I have vasospastic angina and microvascular angina.

I tend to experience a higher heart rate, rather than a lower one when my arteries go into spasm. This is my heart trying to compensate for the reduced blood flow to the heart muscle.

Microvascular angina occurs as a result of the smaller blood vessels not being able to deliver enough oxygen to the heart muscle due to them failing to dilate in response to exercise or movement, or going into spasm whilst at rest. This may cause the heart rate to either go up or down due to the reduced blood flow and oxygen to the heart. Sometimes ECG changes are seen as a result of this.

Another reason maybe due to your medications. I experienced bradycardia (low heart rate) whilst on a calcium channel blocker for my vasospastic angina. I remember also being more fatigued than usual with the lower heart rate. This resolved over a couple of weeks.

It would be wise to ask your GP for a medication review as soon as possible to determine the cause of the lower heart rate. Mine usually dipped without me realising as they were very quick fluctuations. Yours I noticed, are lasting longer so it would require further investigation.

If at anytime you are experiencing other symptoms with the low heart rate such as chest pain, and it is not relieved by using GTN, 1-2 puffs 5 minutes apart after the first two rounds; providing you have been given one, call 111 for advice or 999 should you feel you need it.

All the best.

Tos

[gasp1 in reply to Tos92]

many thanks for that it’s just shaken me abit as it happened when listening to radio I do get fatigued but I try to stay active twitch walking and gym on my days of at work otherwise I pile the weight on 😂I am on Bisoprolol and have noticed people having suffered fatigue with taking this I will book an appointment with dr to discourse to see if they are connected many thanks

[PinkMarshmallow in reply to gasp1]

Hi,I too suffered a low heart rate & fatigue whilst on bisoprolol & told to stop it by A & E Dr.

Also took Atenolol & this made my heart rate drop even lower.

Am waiting for an appt with cardiologist.

Best wishes

[Ennasti]

You may need your meds adjusted or they may say it’s ok. Did you have any symptoms? Mine drops very regularly below 50. At one point I had to change the alert setting to 45 so I didn’t get so many warnings! My doctors are ok with it as long as I don’t have symptoms. I do sometimes get dizzy with it but mostly it happens when I’m sitting still or sleeping.

[Scotsman53]

Since I started on bisoprolol mine goes that low quite often. I have an ILR so the cardios will be aware and nothing's been said so I suppose they're ok with it. The reason I'm on the betablocker is due to the ILR reporting spells of high HR.

[Pitt12345]

I had to stop wearing my watch as it was showing low to mud 50’s particularly overnight. Sent me to see cardiologist and had three heart rate monitors last one for seven days . It didn’t show these low drops the lowest was 58 . It turns out that the ectopics I have daily are the result as the watch couldn’t recognise a heart beat when they occurred and therefore showed very low rate. My watch is a new Apple but I tried Garmin too.

[Ennasti in reply to Pitt12345]

This is a common issue. My drops are due to multiple things including ectopics and pauses.

[Lexi72]

hi gasp 1 , I think that there is a lot of variation in the resting heart rate. What is normal for some people is not for others. Mine is about 46 (am on biospropol too which pushes it down) and can go into high 30s overnight. My cardiologist told me if I am feeling faint they will review the meds but wanted me to stay on it to control ectopics and was not concerned in my case. If your resting heart level has fallen I would raise it with your doctor to give you peace of mind and make sure that there is not a specific reason for the fall best wishes

[CyclingTime]

I do a lot of exercise and my resting heart rate is 43. 48 if you are on meds doesn't doesn't sound super low.If you suffer things like dizziness when standing up quickly then go to the doctors just to get a check

[Andyman]

My heart rate is always in the 40s. I was told not to worry about unless it drop to below 40. That only happens occasionally when I sleep. I sometimes get up from sitting too fast and I get head rush because the blood has not pumped to my head fast enough but I have learned to get up slowly.

Apart from that I have no issues.

[L8Again]

FWiW, my wife has a pacemaker set to a minimum HR of 60bps. It was fitted after a series of heart pauses lasting over 20 secs. She wears an Apple Watch which often shows a heart rate below her pacemaker setting.

Her Cardiologist and pacing team confirmed that was an anomaly associated with the way that these devices monitor HRs. This why these smart devices are not approved for medical diagnostic purposes.

[Yellow26]

Hi Gasp

I have AF on medication for life, I wouldn’t take much notice of the iwatch , my rate used to go down to under 40 beats, the advice I got from my cardiologist was to not wear the watch as it can cause you to panic and give you anxiety.

Good luck

[DWizza]

Hi Gasp1, my resting heart rate has always been quite low , around 50bpm and below. It set the alarms off regularly while I was in hospital last july following Nstemi heart attack and had quadruple bypass. The nurses turned the alarm off as it was a nuisance 🤣.

I’m on 1.25 mg bisoprolol ( reduced from 3.75, couldn’t function on that ) plus a half a 1.25mg tablet Ramipril , clopidogrel, pantaprazole, aspirin and 10mg Rosuvastatin at the moment. My heart rate is regularly on the 46-50 range now. I use a chest strap heart rate monitor for training , garmin devices to record (always used them since cycling with a club years ago and running , did a couple marathons 🤦🏼). I trust my garmin device as much as my blood pressure monitor for home recording. It’s a constant and gives me a good idea of what’s going on. However , I don’t have vasospastic angina . Some good advice already given by others 👍🏻

[Sleepyzz]

mine often goes as low as that especially in the evening. Drs not concerned as long as feeling well

[Greencat59]

My heart rate sat in the 40’s when on a higher dose of Bisoprolol and when zi came off this medication it sat in the 90’s at rest- I went back on Bisoprolol but on a lower dose that no longer made me feel so fatigued and dizzy. I stopped wearing my monitor watch as I was becoming too organised and worried by it. Please get medically checked if you continue to be worried or feel unwell

[Class52]

I’d be pleased if my heart rate was so low w

[Alison_L]

My ICD is set to pace me if my heart rate drops below 40, which it does 0.5% of the time, according to the pacing clinic. I get worried if it doesn’t drop below 50 at night because it means I haven’t had a good, deep sleep. It regularly drops below 50 in the evening when I’m watching TV. As long as you’re not feeling dizzy or sick, it shouldn’t be a problem xx

[Chinkoflight]

Hi, have you always had a low heart rate or is this recent? I have sinus rhythm bradycardia and my resting HR is typically 40 with a range 37-44. Since going on to Bisoprolol at a low dose 1.25mg I have had occasional HR at 33-35 when super relaxed and low breathing rate. I have other heart issues but the bradycardia for me is not related and I continue to live with it. This is in the limits of current research knowledge.

Re Alison L response above, I do have a pacing ICD fitted as well which was set at 60 bpm because of the bisoprolol, but has since been adjusted to kick in at 33bpm, as a safety at night. In hospital my HR dropped to below 30 in my sleep following starting bisoprolol , before the ICD was fitted. I was shaken awake by an anxious nurse!!

[Bingo88]

Good morning gasp1. You need to get this checked out with your doctor or ring 111. That heart rate is too low. Mine was the same and I ended up having a pacemaker fitted. Take care and hope you get some help. Brian

[Kbkk]

Hi, when I was on 5mg Bisoprolol once a day my bpm were always dropping below 40 for over 10 minutes at rest….according to my Apple Watch. After 3 days of it continuously falling to low 30’s (31-33) over three days I went to A & E . They said as long as I wasn’t dizzy or passing out not to worry about it…..as did my cardiologist when I saw him a month later. I’ve since changed to Nebevilol 5mg and bpm are now between 45/50 most of the time. Slightly unnerving when watch is constantly bleeping with low bpm but no one I’ve seen has been concerned….not sure if that’s a good thing or not!!

[Emoryrich]

Thanks for sharing this -- very useful because I have similar concerns. As KBBK replied, it's unnerving to see such numbers.

My doc, and the docs of other people here, tell us that unless we feel bad or are unable to function, the numbers themselves should be of no concern.

Easier said than done, however. My wearable has twice -- appropriately -- advised me to seek emergency care. I have no answer, but it's encouraging to see that I am not the only one who wrestles with thoughts similar to yours.

My bisoprolol has just been upped and I am considering removing my "wearable" and putting in in a drawer for a bit. At the very least I will shut off the warning beeps and buzzes.

May we both find some peace.

[Smitty1956]

Hi, gasp1,

Hopefully, someone else will have replied to you with some helpful advice, but I will add this two cents’ worth as well.

I believe that when you got your Apple Watch, you likely set your Health notification warnings for heart rate that is too high or too low. For example, I set my “too high” warning for when my heart rate would be 160 bpm, or more, for 10 minutes. Thankfully, that warning was only once when I had my HA in 2022. Actually, I set the warning notification on my Watch after my HA. I also set my “too low” notification then too.

I would suggest that you speak with your doctor about your heart rate. S/he is aware of your specific heart health and all of the medications that you are currently taking. You might ask if a heart rate of 48 bpm for 10 minutes is dangerous for you. You may need additional testing or a change in medications.

It is terribly scary for us when our hearts beat too fast or too slowly, and we know that so much is on the line. I hope that you can get all of this sorted quickly and feel better! ❤️