March 17, 2023

Low Heart Rate: What It Is and When to Worry

Bradycardia, or a low heart rate, is more likely as you age — and could be a sign of health issues

Two people exercising in part with heart rate monitor watch in foreground.

You expect your body to slow down a bit as you age, but if the same slowing happens with your heart, is that a good or a bad thing?

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

A slow heart rate (or a low heart rate) is known as bradycardia and occurs frequently in older adults.

“As people get older, there is occasional normal wear and tear on the electrical system of the heart,” says cardiologist Jose Baez-Escudero, MD. “As a result, the normal rhythm tends to slow down.”

Dr. Baez-Escudero shares when to worry about low heart rate — and the signs and symptoms to watch for.

What is a low heart rate?

What does a low heart rate mean? Doctors consider a low heart rate to be 60 beats per minute (bpm) and below. In fact, if you have bradycardia, you’ll have a low resting heart rate below 60, even when you’re awake and active. In contrast, a normal range is 60 to 100 bpm while awake.

It’s very possible to have a slow heart rate and experience no symptoms. However, if you have symptoms but ignore them, it can sometimes cause more serious problems.

Consult a healthcare provider if you’re experiencing some of these symptoms and you have an associated slow heart rate:

What heart rate is too low? If your heart rate is slow (below 60 bmp), but you don’t have symptoms, there’s no reason to worry. But it’s a good idea to know the signs of trouble because bradycardia in some cases does require treatment.

For example, if your heart rate drops into the 30s, you might not get enough oxygen to your brain, making fainting, lightheadedness and shortness of breath possible. Blood can also pool in your heart chambers, causing congestive heart failure.

Advertisement

Do low heart rate ranges change with age/activity?

For most people who are younger, highly trained athletes and people who work out regularly, a low heart rate while exercising — defined as below 60 bpm — is normal and healthy. If you’re physically active, your heart pumps blood more efficiently.

The same goes for your nightly snooze. It’s normal to have a low heart rate while sleeping. When you’re asleep, your heart rate normally slows down to 40 to 60 beats a minute.

What causes low heart rate

Many things can bring on a slow heart rate. Low heart rate causes include:

Heart malfunction

The most common cause of bradycardia is a malfunction in your heart’s natural pacemaker, the sinus node. It controls how quickly the top and bottom heart chambers pump blood through the body.

AV block

Another cause of bradycardia is an atrioventricular block (AV block), in which the top and bottom chambers don’t communicate well and your heart rate drops as a result.

“It’s like having virtual electrical cables and wires inside the heart,” Dr. Baez-Escudero says. “These deteriorate as we age. Common medications used in older populations can also often make bradycardia more significant.”

Age

Age is the most common risk factor for developing bradycardia. The condition is most common among men and people assigned male at birth and women and people assigned female at birth over age 65.

Certain illnesses or conditions

Illness or other conditions may also cause bradycardia. These include:

Advertisement
  • Heart attacks due to coronary artery disease.
  • A bacterial infection in the blood that attacks your heart.
  • Inflammation of your heart muscle.
  • Low thyroid function.
  • An electrolyte imbalance.
  • Too much potassium in your blood.
  • Certain medications, including beta-blockers and antiarrhythmics.
  • Congenital heart defects, diabetes or long-standing high blood pressure all may make bradycardia more likely, says Dr. Baez-Escudero.

When to worry about low heart rate

If you’re concerned about a low heart rate, visiting your physician can help determine the causes. Your healthcare provider will first ask about your usual activities and conduct a physical exam.

They may use an electrocardiogram (EKG) to measure the electrical signals in your heart, in order to see whether they’re firing correctly. Wearing a 24-hour monitor can also help your doctor see how your heart performs over time.

Once they decide you might need treatment, your provider will try to rule out medications or other pre-existing conditions as causes. Sometimes, changing medications or similar strategies can solve the problem.

If not, implanting a pacemaker via minimally invasive surgery is the only option to speed up your heart rate, Dr. Baez-Escudero states.

But he notes that bradycardia isn’t often an emergency, so providers have time to choose the right treatment.

“In general, bradycardia allows time for us to evaluate the condition and rule out if any other condition is responsible,” Dr. Baez-Escudero says. “Then, we can adjust medications or take other steps if we need to.”

Related Articles

Aspirin poured onto table from bottle
December 7, 2023
Why You Are Sensitive to Aspirin

A reaction to the medication may trigger preexisting asthma and result in sinus or skin reactions

Person lifting up their sweater, showing ostomy bag in mirror's reflection
December 6, 2023
Adjusting to Life With an Ostomy Bag: What To Expect

It can be hard to get used to the bags, but the freedom they provide is worth the challenge

Happy caucasian woman hiking in forest
December 6, 2023
Forest Bathing: What It Is and Its Potential Benefits

Immersing yourself in nature can improve both your mental and physical health

Woman looking in mirror and pulling skin until wrinkles disappear
December 6, 2023
Should You Add Collagen Supplements to Your Skin Care Routine?

Though popular with influencers and celebrities, there’s little research to back up claims that they work

A vaccine syringe in front of a passport for international travel.
December 5, 2023
Which Vaccines Are Required To Travel?

Plan early — getting the right vaccines can help you stay healthy on your travels

Person overheated lying on chair on the beach; heart rythym next to him
December 5, 2023
How the Heat Can Affect Your Heart

Sizzling temperatures force your heart to work much harder

nocovaine needle entering mouth with dental mirror
December 4, 2023
How Long Does Novocaine Last?

The numbness and tingling should wear off in about two hours

bearded man sitting crosslegged holding clock in one hand, calendar in other
December 4, 2023
Are Bare Minimum Mondays Good for Your Mental Health?

Rethinking your Mondays might make the ‘Sunday scaries’ a thing of the past

Trending Topics

group of hands holding different beverages
November 14, 2023
10 Myths About Drinking Alcohol You Should Stop Repeating

Coffee won’t cure a hangover and you definitely shouldn’t mix your cocktail with an energy drink

Person applies moisturizer as part of their skin care routine after a shower.
November 10, 2023
Korean Skin Care Routines: What You Need To Know

Focus on the philosophy — replenishing and respecting your skin — not necessarily the steps

glass of cherry juice with cherries on table
November 8, 2023
Sleepy Girl Mocktail: What’s in It and Does It Really Make You Sleep Better?

This social media sleep hack with tart cherry juice and magnesium could be worth a try

Ad