Low exercise pulse sometimes - anything to be concerned at?

[bmwmike]

Hello

Lots of good info on this subforum so thought i'd ask this for (hopefully) reassurance too.

I've had a resting awake pulse as low as 34 (avg 50) lately and aside from more palpitations than usual over last six months, absolutely no other symptoms. I spoke to the GP who did a ECG, result seemed "not quite right" (no other details), and was referred to cardiologist. Spoke to cardiologist consultant and he said it was a sign i was relatively fit and not to worry as ECG looked completely normal. I do offroad cycle 4-5 times a week. Great - normal!

OK all good.

What i forgot to mention to the consultant and the reason for this post - most times when i exercise my pulse gets high, like 180 odd, but sometimes, maybe 1-2 times out of 10 for the same route and same effort it seems to stay low, like 100-110. Again, no symptoms of dizziness or palps. When i do get palps, it tends to be 80-100 and at rest or low activity.

Is that low exercise figure something to be concerned at? It is a wrist monitor and not strap, so they can be inaccurate, but double check manually gives a similar ballpark number. Don't want to go back to GP as its been a hell of a year with close family bereavements and ongoing family health issues that im already on first name terms for the kids etc, an dont want to go back unnecessarily for myself.

Thanks

[BoRED S2upid]

Is it a cheap wrist monitor? Be good to rule out inaccurate readings rather than anything of concern. Same ride with the same effort should be fairly consistent. I know my rides on strava are almost identical heart rate for the same routes when monitored with a iwatch.

[bmwmike]

No its a decent garmin smart watch type thing. A manual check corroborates the reading though.

[popeyewhite]

Go get another ECG at the hospital. Do GPs have enough specialised training to interpret ECG results to the same depth as a committed department at a local hospital?

[Derek Smith]

I used to cycle 200 miles a week in the summer, most of it off-road.

I was skinny and had a rate of around yours, 45-55. Resting was lower, but it varied a bit more.

Seen by my doctor who sent me to see a 'specialist' who said, more or less, what did I expect.

As I got older (that was in my middle to late 30s) my rate went up a bit.

I'd perhaps opt for a more frequent ECG, but wouldn't necessarily be concerned if no other symptoms. If you doctor's fine about it, and you trust him . . .

[bmwmike]

thanks

I'm 100kgs and nearer to 50 than 40

Got an appt for a 7 day monitor in the post today so perhaps the doc had more thoughts about it after our phone call.

[cheeky_chops]

I have similar low hr resting, sometimes 32 overnight. Riding steep hills im blowing but cant get heart rate above 160 (50 next week) been like it for years. 6+ years ago i noticed occasional palpitations and went to dr who referred me to cardio, portable hr monitor and said within normal tolerances. You can get meds if arrhythmia bothers you too much but i didnt.

Roll on covid, i had one ride where i was just knackered, couldnt get hr up, went home early. Felt crap and had terrible palpitations, erratic hr, light headed, 111 advised me to go to A+E. This was in middle of 1st lockdown! Missus sat outside in car for 7 hrs..... I ended up in cardiology, was given immediate all clear and to see outpatients - he told me to relax, stop drinking coffee/alcohol as he thought palpitations were anxiety/stimulant driven. Out patients, hr monitor said same thing, I was drinking a fair bit of strong filter coffee every day so only drink decaff now. A good few sessions on the pop introduces night palps so need to be conscious of that. Also worrying about life/stuff brings it on - i didnt think i worried much but covid has made me quite anxious, sometimes depressed esp during lockdowns.

Couple of things - def take the heart monitor as atrial fib is possible/dangerous. Just after my hospital visit, i was really suffering with palps, I used my wifes apple watch which can monitor for atrial fib patterns too - it put my mind to rest as i ended up having a panic attack (never had one before) at its worst but the week after hospital it returned to previous levels. One thing ive found via google quite useful is breath in, holding your breath and trying to blow out for 5 secs a couple of times. Also my wife was amazing - shes a dentist and helped immensely so discuss with OH/someone.

Good luck with checkup its the best thing - at the time it was all very un-nerving

[bigandclever]

The problem with optical HR wrist monitors is they're just not reliably accurate.

[bmwmike]

bigandclever said:

The problem with optical HR wrist monitors is they're just not reliably accurate.

No, agreed, hence why i checked manually (fingers and count) and it was similar to the device reading.

[bmwmike]

cheeky_chops said:

I have similar low hr resting, sometimes 32 overnight. Riding steep hills im blowing but cant get heart rate above 160 (50 next week) been like it for years. 6+ years ago i noticed occasional palpitations and went to dr who referred me to cardio, portable hr monitor and said within normal tolerances. You can get meds if arrhythmia bothers you too much but i didnt.

Roll on covid, i had one ride where i was just knackered, couldnt get hr up, went home early. Felt crap and had terrible palpitations, erratic hr, light headed, 111 advised me to go to A+E. This was in middle of 1st lockdown! Missus sat outside in car for 7 hrs..... I ended up in cardiology, was given immediate all clear and to see outpatients - he told me to relax, stop drinking coffee/alcohol as he thought palpitations were anxiety/stimulant driven. Out patients, hr monitor said same thing, I was drinking a fair bit of strong filter coffee every day so only drink decaff now. A good few sessions on the pop introduces night palps so need to be conscious of that. Also worrying about life/stuff brings it on - i didnt think i worried much but covid has made me quite anxious, sometimes depressed esp during lockdowns.

Couple of things - def take the heart monitor as atrial fib is possible/dangerous. Just after my hospital visit, i was really suffering with palps, I used my wifes apple watch which can monitor for atrial fib patterns too - it put my mind to rest as i ended up having a panic attack (never had one before) at its worst but the week after hospital it returned to previous levels. One thing ive found via google quite useful is breath in, holding your breath and trying to blow out for 5 secs a couple of times. Also my wife was amazing - shes a dentist and helped immensely so discuss with OH/someone.

Good luck with checkup its the best thing - at the time it was all very un-nerving

Thanks, yeah, i'll do the monitor i think. Had covid too and my exercise tolerance dropped off a cliff too - took the best part of 6 months to get it back and even now i don't feel its 100% of where it was before i had covid. Glad you got it sorted.

[boyse7en]

anonymous said:

[redacted]

Depends how low. Girl in my running club had low heart rate issues and kept having blackouts, to the extent she has lost her driving licence. She runs sub 3hr marathons, so must be pretty fit, but she has now got some sort of implant that kicks off if her heart rate falls too much.

[cheeky_chops]

bmwmike said:

bigandclever said:

The problem with optical HR wrist monitors is they're just not reliably accurate.

No, agreed, hence why i checked manually (fingers and count) and it was similar to the device reading.

Ye[p, on the bike if i dont have watch strap tight on my wrist its all over the place esp in certain hand positions on road bike. While on sofa its accurate comparing to the old method finger on wrist/timer

[bmwmike]

Been offered a 7 day ECG but I think i'm gonna decline and let someone else have the slot. I was mulling this over as i was riding up a 15% gradient yesterday. There can't be much wrong if i can do that.

[ovlovlover]

bmwmike said:

Been offered a 7 day ECG but I think i'm gonna decline and let someone else have the slot. I was mulling this over as i was riding up a 15% gradient yesterday. There can't be much wrong if i can do that.

Most likely but if your concerned a 7 day ECG wouldn't hurt.

Could be over training. 100/110 sounds very low respectively but your heart gets tired too and sometimes just can't do it anymore.

Does the low hr correlate with high intensity workload/low rest period +/- poor sleep high stress?

[millen]

I was put on a 24-hr wearable ECG shortly before lockdown, so that might be a more practical alternative? I'd assume 7 days wouldn't yield much more information than 24 hrs, so long as you get decent strenuous activity in that time period, unless the problem is particularly intermittent. In my case though, the GP said there was nothing to fret about and I never was shown any hard numbers.

[popeyewhite]

ovlovlover said:

Could be over training. 100/110 sounds very low respectively but your heart gets tired too and sometimes just can't do it anymore.

If it were chronic overtraining there would be several other very easily recognised symptoms. Raised cortisol/epinephrine, complete inability to sleep, constant nausea, nonexistent libido etc etc. Symptoms are persistent and constant until total rest is taken.

[Derek Smith]

I tried a pulse monitor for my cycle ride, off-road, to and from work. The only reason I did was that it was available, and not for any medical reason.

There were two steep climbs on the way back, both approached by a mile or more of flat. My pulse increased sharply before the climbs started, in the case of the first one, well before. Both climbs started slowly and my pulse dropped after the initial peak at the bottom, although it hit it highest near the top.

For the second climb, it's an easy ride after, and my pulse rate dropped before I breasted the rise.

There's more to this heartbeat stuff than just demand. Anticipation seems to affect it, and both before and after.