Your connected watch displays 48 or 55 beats per minute at rest: should you be worried? Not necessarily. A heart can beat slowly in a very trained person, during sleep or in a situation of complete rest. But a new, unusual, or symptomatic slowdown should be taken seriously. Health Insurance points out that heart rate varies depending on age, physical training and the time of day, and that the diagnosis of a rhythm disorder is not based on a simple isolated number.
“When faced with a slow heart, the right question is not only “how many?”, but “in what context and with what symptoms?”. explains Dr. Gérald Kierzek.
In practice, if you feel good, the measurement is timely and you are active or resting, there is no need to panic. On the other hand, if the slow pulse is accompanied by dizziness, shortness of breath, unusual fatigue, falling or feeling unwellmedical advice should be sought.
A pulse below 60: a benchmark, not a diagnosis
We often speak of bradycardia when the heart beats slowly, especially below 60 beats per minute in adults. But this threshold is not enough to classify the situation as dangerous or benign. A trained person can have a low resting rhythm without it being pathological. Conversely, a pace that is only moderately slowed may be poorly tolerated in another person.
To understand your resting heart rate, you must take into account the time of measurement, recent activity, sleep, possible fever, training level and current treatments.
“A watch may attract attention, but it does not replace a clinical examination or an electrocardiogram” recalls Dr. Gérald Kierzek.
Health Insurance indicates that the main test to look for a rhythm or conduction disorder is the electrocardiogram. If the episodes are brief, rare or occur in special circumstances, a longer recording, such as Holter ECG, may be offered.
Signs that should prompt consultation
The key point is the symptoms. Unusual fatigue, shortness of breath, dizziness, loss of balance, falling or brief loss of consciousness
are among the signs described by Health Insurance in heart rhythm disorders. They do not alone prove that the heart is involved, but they justify not remaining with a simple interpretation of a watch.
You should contact your doctor or a medical service if the slowdown is new, repeats itself, appears during usual exercise or changes your ability to do your normal activities. To identify the signs of bradycardia to monitor, the association between low number and feeling is often more informative than the isolated value.
“Dizziness, discomfort, shortness of breath or a clear drop in fitness: these are the signals that should take you beyond the simple “I’m watching”” underlines Dr Gérald Kierzek.
Call 15, 18 or 112 in case of chest pain or tightness, significant difficulty breathing, severe discomfort or loss of consciousness. In the event of an unconscious person who does not react and does not breathe normally, calling for help, cardiac massage and the use of a defibrillator if available are priority.
Medications, ECG, monitoring… Good reflexes
Before the consultation, note the useful elements: time of the episode, frequency displayed, duration, current activity, associated symptoms, circumstances of occurrence and possible screenshots. Also bring a list of your treatments, including eye drops, supplements and medications taken occasionally.
Certain treatments can slow down the heart or cause conduction problems. The ANSM cites in particular beta-blockers, certain calcium channel blockers such as verapamil or diltiazem, amiodarone or even digoxin. However, you should not stop a prescribed treatment alonein particular a beta-blocker, the cessation of which must be medically supervised and sometimes gradual depending on the context. You can also read again why certain treatments can slow down the heart.
“If a medication is involved, the solution is not to stop it in its tracks, but to speak quickly to the prescriber” insists Dr Gérald Kierzek.
An isolated low measurement, without disturbance, can therefore simply be re-checked under good conditions. But an unusual, repeated or poorly tolerated slow pulse merits medical advice, and severe signs require calling for help.