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Resting Heart Rate (Read 2568 times)

    I recently had a physical and expressed some concerns about some shortness of breath.  It's a problem I've had on and off for several years and I've always attributed the problem to anxiety.  I can go months or years with no issues.

     

    Anyway, she checked my heart rate and knew immediately that I was physically active but decided to run an EKG anyway,  That test showed a resting heart rate of 47 bpm.  She immediately got concerned and ordered a metabolic panel and thyroid test to be done with my regular blood work and a stress test.  I haven't gotten the results from the blood work yet and the stress test isn't for another week or so.

     

    This seems like a lot of worry for a 33 year old female in otherwise excellent health.  Is it the breathing or the heart rate (or the combination) that has my doc so cautious?  And has anyone else had this problem?

      I recently had a physical and expressed some concerns about some shortness of breath.  It's a problem I've had on and off for several years and I've always attributed the problem to anxiety.  I can go months or years with no issues.

       

      Anyway, she checked my heart rate and knew immediately that I was physically active but decided to run an EKG anyway,  That test showed a resting heart rate of 47 bpm.  She immediately got concerned and ordered a metabolic panel and thyroid test to be done with my regular blood work and a stress test.  I haven't gotten the results from the blood work yet and the stress test isn't for another week or so.

       

      This seems like a lot of worry for a 33 year old female in otherwise excellent health.  Is it the breathing or the heart rate (or the combination) that has my doc so cautious?  And has anyone else had this problem?

       

      I wouldn't want to take it too lightly and say "No problem whatsoever!!" but, personally, I don't see any concern in regards to your HR being very low of 47.  That should not be of ANY concern except that it shows your, like you said, excellent physical condition.  My HR, at my peak, was 37 and most world class endurance athletes have resting HR of 40~45 or less.  You don't have to be a world class athlete to have a very low HR; and some elite athletes may even have rather high HR as well (Jim Ryun had 60+) so it's not a general determining factor; but, in general, a person with a good endurance condition has lower than normal resting HR.  Some doctors seem to be unable to grasp that concept, surprisingly, and still be alarmed with low HR.  That's a practice of the 1950s and 60s.  Is he an old man? ;o)

       

      Like I said, however, I would not just single out the bpm as the indication of being concerned or not being concerned because it really doesn't tell much.  Of course, as you should know, you don't need to run EKG to determine your resting HR.  If the doctor saw anything unusual on your EKG, that's a totally different story.  I would suggest you ask a bit more detail about what is so concerning and possibly see another doctor for the second opinion.

       

      A few years back, we rewrote my life insurance.  An agent came to my house and took an EKG.  They immediately raised a red flag and declined my life insurance.  I've had this problem ever since I was 10-year-old when a doctor told us (me and my mom) that I shouldn't run, that there was some issue with my heart.  It turned out, one of the spikes on the graph was heading the opposite direction (supposed to go up but mine was down or something...).  Of course, I was 10 then and I started running when I was 12...till now (so 21 years??? ;o)).  So I sort of knew what it was.  So I went to this doctor and he took, whatever you call it, kinda fancy stuff, it's an MRI but in a live-action--you can see my heart beating in a shadowy image like one of those ultra sound baby images.  What he told me then, and it sort of cleared all the "concerned" over the years (not that I was really concerned...) was that my heart was tilted a bit more than normal and this particular "spike" on the graph happened to be where it's not supposed to be.

       

      If you are worried about it, I would definitely ask your doctor a bit more in detail what it is that he's worried about and why.  If that doesn't really clear your thought, get the second opinion from other doctor(s). 

       

      As for shortness of breath, breathing is often (in most cases) feedback from the muscles.  You may have an excellent heart condition but, if your working muscles are not getting enough oxygen and/or using oxygen efficiently, then your body would signal your brain that it's not getting enough oxygen and you'll start to breathe more heavily.  In essense, anxiety is the same effect, different cause.  I couldn't tell if you are worrying type or not--I think you know better. 

        You don't have to be a world class athlete to have a very low HR; and some elite athletes may even have rather high HR as well (Jim Ryun had 60+) so it's not a general determining factor; but, in general, a person with a good endurance condition has lower than normal resting HR.  I would suggest you ask a bit more detail about what is so concerning and possibly see another doctor for the second opinion.

         

         

        +1

         

        I've been fairly active most of my life, but only started running 6 years ago at 57 when I got older.  I'm a slow runner but have a  RHR of 35 and usually it's in the low-mid 40's during the day. (Believe me, I'd much rather have a "normal" HR & be faster!).  When doctors see my HR they get concerned right away, but when I explain that I'm a runner, they relax and continue...however, the "shortness of breath" (no matter how infrequent) should be checked.  Is it related? I doubt it, but I really don't know.

         

        Good luck! 

        "I can do 440 in 220"    Half Fanatic #846    "90% of running is half mental"    If I collapse, please pause my Garmin

         

          Thank you for the feedback.  My stress test is next Monday and I'm interested in what (if anything) shows up on it.  Personally, I think the breathing is anxiety related and not anything huge to worry about...but I appreciate that my doctor wants to rule out significant causes.  Hopefully I will hear something soon.

           

          A friend of mine that I run with experienced almost identical symptoms a few months back and was annoyed that her doctor didn't try to rule a few things out.  Like me, her breathing got better and she hasn't had any issues since.  The only difference was that this was the first time she experienced it whereas I have had this issue on and off for 8 years.


          Feeling the growl again

            By itself, a low HR in an endurance athlete/regular runner is perfectly normal and USUALLY nothing to worry about.  However, with shortness of breath present, or any other potentially related symptoms, it is a good idea to be checked out, for sure.  It may be anxiety, but it may be something else.

             

            That said, there are legitimate medical reasons HR may also be low unrelated to exercise and some are potentially serious.  Some docs cannot get past that and will try to run them on everyone they see with a HR <60, no matter their exercise level.  I had a friend, in 31:30 10K shape, have to go through a 24-hr EKG just to get cleared on his work physical because his HR was 55.  He tried to explain his exercise level to the doc but she did not care.

             

            Last summer while I was training well I took a day off...scratched my cornea and my wife pressured me to go to the ER to get checked out as the pain level was very high.  Of course the first thing they did was take blood pressure (normal) and pulse....28, a new record for me.  The tech looked at me with a shocked look and took it again...29.  "Please tell me you run marathons," he said cautiously.  When I affirmed my fitness level he said good, because if I did not he was going to have to hit the emergency call button.  ;D

             

            MTA:  If you showed a doc a chest X-ray of a serious runner of many years without the context of their activity they may want to test them for congestive heart failure as their heart would be enlarged.  However the way a runner's heart enlarges is very different from CHF, but at first glance it can appear similar.

            "If you want to be a bad a$s, then do what a bad a$s does.  There's your pep talk for today.  Go Run." -- Slo_Hand

             

               "Please tell me you run marathons," he said cautiously.

               

              It's a good thing you do run marathons.   If you only ran 10ks or something, you would have been in big trouble. 

                10k marathons are fine by the way.


                Feeling the growl again

                  It's a good thing you do run marathons.   If you only ran 10ks or something, you would have been in big trouble. 

                   

                  Well, I gave the guy credit for that question, even though he was "only" a tech, being the first thing out of his mouth instead of just hitting the panic button!

                  "If you want to be a bad a$s, then do what a bad a$s does.  There's your pep talk for today.  Go Run." -- Slo_Hand

                   


                  A Dance with Monkeys

                    An ECG with a HR of 47 and no other abnormality is reassuring, however the shortness of breath needs to be evaluated.  If the two are related, it could indicate a serious heart or lung problem.  If they are not related (as I suspect) then the diagnosis may be more benign.  I am not sure what the thyroid panel or chemistries would show in this case, but I am glad somebody is thinking about it.

                     

                    I agree with a stress test.

                    Shoe


                        I am not sure what the thyroid panel or chemistries would show in this case, but I am glad somebody is thinking about it.

                       

                      Doesn't hypothyroidism cause shortness of breath and slow heart rate?


                      A Dance with Monkeys

                        Not shortness of breath, typically.


                        Feeling the growl again

                          Doesn't hypothyroidism cause shortness of breath and slow heart rate?

                           

                          I've never heard shortness of breath associated, slow HR perhaps.  Excessive sleepiness/fatigue, low basal temp are more classic.

                           

                          If your thyroid is low enough to really lower your HR you probably have other bigger symptoms evident.  I was relatively recently started on a low dose of thyroid medication and while there has been moderate improvement in symptoms my resting HR has not perceptibly changed.  I do know someone who had a really low HR when diagnosed with thyroid disorder but their thyroid was so low that the doc said they should have been dead before they got to the office.

                          "If you want to be a bad a$s, then do what a bad a$s does.  There's your pep talk for today.  Go Run." -- Slo_Hand

                           


                          A Dance with Monkeys


                          Feeling the growl again

                            Wikipedia says shortness of breath is uncommong.

                             

                            (I've never heard of it happening)

                             

                            Trent quoting Wikipedia...heh heh.... Wink

                            "If you want to be a bad a$s, then do what a bad a$s does.  There's your pep talk for today.  Go Run." -- Slo_Hand

                             

                              I resisted commenting on that. luckily Spaniel has done it for me.

                               "Don't walk in front of me; I may not follow.  Don't walk behind me; I may not lead.  Just walk beside me and be my friend."

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