Slow heart rate below 60 beats per minute? Cardiologist warns when to get your heart checked

Know what it means when your heart rate drops below 60 beats per minute. Doctor shares when to seek medical help.

The heart is a complex organ, and any sudden changes can indicate that something is not right. Many people monitor their beats per minute, but there is a threshold to be aware of, beyond which it may indicate an underlying dangerous condition, both the upper and lower limits. For the lower limit, a heart rate that consistently falls below 60 beats per minute may require attention. It must be dealt with seriously.

In a conversation with HT Lifestyle, we asked Dr Nityanand Tripathi, principal director and HOD- cardiology and electrophysiology at Fortis Hospital, Delhi.

Heart's beat per minute can tell a lot about your heart's health!

Describing which condition this is, he said, “A slow heart rate, often known as bradycardia, is defined as fewer than 60 beats per minute.” But bradycardia, he mentioned, despite being normal in athletes or during sleep, when you begin to monitor a persistently slow pulse, along with a certain type of symptom, you should not brush it aside.

Why is this dangerous? The cardiologist said, “Bradycardia often remains undetected because its signs are subtle, intermittent, or mistakenly attributed to stress, fatigue, or the natural process of ageing.”

Why does bradycardia develop?

The doctor explained that the heart’s rhythm is controlled by the sinoatrial (SA) node, the body’s natural pacemaker. When this electrical system weakens, degenerates, or malfunctions, the heart may fail to pump adequate oxygen-rich blood to vital organs. Over time, reduced circulation can affect brain function, physical stamina, and overall well-being.

Signs you should not ignore

Dizziness is one of the alarming symptoms. (Shutterstock)

A slow heart rate is accompanied by other signs. Monitor closely for other signs! Combined, they tell you when to visit a doctor. Here are some of the signs that the cardiologist revealed that necessitate immediate medical evaluation:

• Persistent fatigue
• Unexplained weakness
• Dizziness
• Light heartedness

Signs which are a bit more ‘concerning’:

• Confusion
• Shortness of breath during routine activities
• Chest discomfort
• Fainting/near-fainting episodes

Who is vulnerable?

Older adults, the cardiologist noted, particularly those above 65 years, face a higher risk of bradycardia due to age-related wear and tear of the heart’s electrical conduction system.

“Chronic conditions such as diabetes, hypertension, and coronary artery disease may further increase susceptibility,” Dr Tripathi said, mentioning which conditions make people more vulnerable to the problem of slow heart rate.

Furthermore, the elderly people, according to the cardiologist, are at higher risk because their symptoms are often misinterpreted as normal ageing, which can delay diagnosis and appropriate intervention.

Diagnosis

For diagnosis, he recommended an electrocardiogram (ECG), as it can identify abnormal heart rhythm, while ambulatory monitoring, such as Holter device, may capture intermittent episodes over 24 to 48 hours. Management depends on the underlying cause and severity and may range from adjusting medications to correcting metabolic imbalances. However, persistent symptomatic bradycardia often requires pacemaker therapy. Similarly, advances in cardiac pacing, including leadless pacemakers implanted directly within the heart, provide minimally invasive solutions with reduced infection risk and faster recovery.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.