EKG from normal to Sinus bradycardia in stage 3b CKD

[Vprp]

My 77 year old husband stable in stage 3b for couple years recently had dizziness and some nausea. PCP did an EKG and found sinus bradycardia. Last EKG two years ago was normal. He has not had any dizzy spells for couple months and his first cardiologist visit advised him to maintain his BP meds etc and said that the low diastolic pressure (52) was nothing to be concerned. He basically dismissed any concern which does not make sense to me, especially since his last ECG was normal. I am his caregiver and I noticed slight increase in swelling in his palms ( none in his feet) and bluish lips. I read that sinus bradycardia can lead to complications like CHF, cardiac arrest. Grateful for advice, tips from anyone in similar situation. 

[Marbella17]

The same thing happened to my dad, we reported bradycardia to his cardiologist at the time who did an EKG but did not tell us that he has a sinus block, his heart rate was 34 at that time yet he sent us home, within 24 hours my dad declined so severely had heart failure, infection, AKI etc. needed dialysis, was in the ICU for a while… it was a horrible and terrifying experience. Thankfully he got a pacemaker installed which paces his heart now at a rate of 60 BPM. Please go for a second opinion if possible, despite your husband being stable right now, it can never hurt to verify especially if you feel that the doctor is being dismissive. Best of luck!

[Vprp in reply to Marbella17]

Thanks for sharing experience with your dad. Shall try to seek another cardiologist/ opinion.

[Marbella17 in reply to Vprp]

Absolutely, best of luck!

[Skinnyblue in reply to Marbella17]

Sorry to know about your dad. Did he get a Pacemaker or a Defibrilator ??

[Marbella17 in reply to Skinnyblue]

Yes, he got a leadless pacemaker placed made by Medtronic (it’s as small as a vitamin pill).

[David100]

I am so sorry to hear about your husband's change. I can see how disconcerting this would be. Although I have not experienced what he is going through, I agree what @Marabella17 said - get a second opinion as what you describe warrants it and we all have to advocate for ourselves in this age of health care. Good luck!

[Vprp in reply to David100]

Thanks, yes, you are correct, we need to be our own advocates in this environment.

Shall try to get another cardio opinion.

[Darlenia]

I want to add my voice to everyone here advising you and your hubby to seek a second opinion. The situation could involve blockages or perhaps even electrolytes. I'm an older lady who passed out (3x) in a restaurant because of extremely low sodium/chloride. It created quite a stir. Thankfully, I wasn't driving a car. I experienced dizziness, very low blood pressure, bradycardia, visual disturbances, weird dreams, odd breathing pattern when sleeping, and so on before that happened. I had largely taken sodium out of my diet to be supportive to my hubby with kidney disease. If my memory serves me right, my diastolic pressure was also in the 50s and the systolic was around 100. (I often suspect that those older folks who "peacefully passed away their sleep" probably had electrolyte issues.) My primary doctor discovered my issue and followed me carefully over a few months until all my electrolyte numbers were again in the normal range consistently. Your spouse's diastolic number is too low in my view, so I would definitely investigate further. It could be something, it could be nothing. But rule out everything.

[Vprp in reply to Darlenia]

Thanks for sharing your experience, it really helps and reinforces decision to seek another cardiologist opinion/visit.

[Dana66CKD]

Are you checking bp routinely? I Am 66 y.o., I am on metoprolol tartrate. My HR usually between 50-60 bpm, sometimes 45-50. Most of my ekg's ok, but then dizziness, & palpitations. Wore monitor 2 weeks and diagnosed w/PSVT's, but bradycardia from beta blocker? On low dose rx. Still have irregular HR intermittently, but no dizziness. Very mild ankle edema when on my feet too long.

Talk to your PCP right away b/c everyone is different and reacts differently to medications. Plus that's just my experience but his doctor should be able to run tests or check labs, etc. Hope his doctor and you can find a solution 🙏

[Vprp in reply to Dana66CKD]

Thanks for sharing. He has never been on beta blocker, only on ACE inhibitors for past 15 years. Also on statin and metformin due to long standing diabetes. I do check his BP often and it varies from 110/55 to 135/75 day to day! Shall follow up with lab tests for electrolytes and GFR.

[Skinnyblue in reply to Dana66CKD]

How do you check your HR at home and how often ??

[Vprp in reply to Skinnyblue]

I check HR by the mobile cuff BP which also gives HR. Few times a week…

[Dana66CKD in reply to Skinnyblue]

My bp monitor does it, but I also check pulse manually with timer on my cell phone and place fingers on/near collarbone, right side of neck. I check once/twice per week or if not feeling well.

[WildIris]

It doesn't sound like a very serious heart problem to me (not a doc), but your doctor should have taken more time with you to explain until you were comfortable or had convinced him/her to do more tests.