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Does Sinus Bradycardia During Sleep Indicate Heart Diseases?

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Posted on Mon, 23 Mar 2015
Question: I had several cardiac tests done twice over the past 6 months. The most recent tests were done last month. I did a stress test, echo, ECG, 2 holter monitors etc... The results of the stress test and echo came back normal showing a structurally normal heart. My holter showed 200 PACS and 15 single unifocal PVCS. I have a resting heart rate which goes around 54 which worries me but my cardiologist says it is normal and my heart is healthy. Also during sleep my heart rate went down to 41. I get worried because when I wake up in the morning I get a lot of what I think are PACS. for example this morning I could feel a lot of them and my heart starts racing. Is this a common thing to happen in the morning? It scares me because my heart will feel fast and then slow. One other thing I noticed that is always on my mind sometimes I will feel like there is a lump in my throat or food coming up. I check my pulse and I can feel it very slow for a few beats and then it will speed up a little bit and slow again. It doesn't happen all the time but it happens a few times the last few days again. I had my thyroid level checked and it said normal. What can it be?
Can it be coming from the esophagus and causing the heart to slow?
doctor
Answered by Dr. Benard Shehu (27 minutes later)
Brief Answer:
GERD may be causing your symptoms...

Detailed Answer:
Hi XXXX!
I read your query very carefully.

As long as recent cardiac examinations were normal (even the recorded 200 PAC, 15 single unifocal PVC and sinus bradycardia during sleep are to be considered normal) you shouldn't worry about cardiac issues.

What you are experiencing early in the morning is normal due to high adrenaline secretion on the early hours of the morning, which may be the cause of PAC and PVC.

Different people feel the palpitations in different way, my opinion is that what you feel is PVCs and compensatory pause that follow them which you experienced as alump on your throat. You shouldn't worry about that.

There are to many causes of palpitations (PAC and PVC). GERD (gastro esophageal reflux disease) may be causing your symptoms, because stomach and esophagus are in close contact with heart and any gastrointestinal distension (from hyperacidity, indigestion etc.) may cause palpitations. I recommend to take antacids to see if this relieve your symptoms.

This is why I strongly suggest contacting a gastroenterologist to exclude GERD or other gastrointestinal problems.

Hope this will be of help!
Wish you health!
Dr. Shehu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Benard Shehu (5 minutes later)
Hi Doctor Thank you for your response. If it is gerd and the heart is healthy, are the slow heart beats dangerous. I feel like sometimes it struggles to beat whe this is happening . Is that dangerous?
Sometimes I will be standing up and my heart rate when I check it is at 60-65 when I have this feeling. Is that normal for my heart rate to be around 65 standing?
doctor
Answered by Dr. Benard Shehu (55 minutes later)
Brief Answer:
What you are experiencing isn't dangerous even if it's caused by GERD.

Detailed Answer:
Hi back,

What you are experiencing isn't dangerous even if it's caused by GERD. It only bother you and increase your anxiety and concerns but as long as cardiac exams were normal there isn't any life risk to you.

Also It's normal for HR to be at 65 bpm when standing and you shouldn't worry about that. My advice is to stay relaxed and to contact a gastroenterologist to exclude GERD.

Wish you health!
Dr. Shehu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Benard Shehu (1 hour later)
Hi Doctor I appreciate your answer as always. One last question I have. With the pvc or pacs I usually get them late at night at rest or in the morning. However over the past week I noticed I've gotten a few during the day. Even while working or driving. After the skipped beat my heart starts to race. Is this also normal for the heart to race after the pvc or pacs?
doctor
Answered by Dr. Benard Shehu (6 minutes later)
Brief Answer:
Following answer to your queries...

Detailed Answer:
Hi again back XXXXXXX

Yes it's normal after each premature cardiac beats is followed by a compensatory pause and by strong beats which are experienced as heart starting to race. you shouldn't worry about that.

Moreover keep in mind that every day activities and stress (work overload) may increase the frequency and intensity of palpitations. I recommend taking chamomile and valeriana tea to relax and to avoid caffeinated drinks.

Wish you health!
Dr. Shehu
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Benard Shehu

Cardiologist

Practicing since :2004

Answered : 2257 Questions

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Does Sinus Bradycardia During Sleep Indicate Heart Diseases?

Brief Answer: GERD may be causing your symptoms... Detailed Answer: Hi XXXX! I read your query very carefully. As long as recent cardiac examinations were normal (even the recorded 200 PAC, 15 single unifocal PVC and sinus bradycardia during sleep are to be considered normal) you shouldn't worry about cardiac issues. What you are experiencing early in the morning is normal due to high adrenaline secretion on the early hours of the morning, which may be the cause of PAC and PVC. Different people feel the palpitations in different way, my opinion is that what you feel is PVCs and compensatory pause that follow them which you experienced as alump on your throat. You shouldn't worry about that. There are to many causes of palpitations (PAC and PVC). GERD (gastro esophageal reflux disease) may be causing your symptoms, because stomach and esophagus are in close contact with heart and any gastrointestinal distension (from hyperacidity, indigestion etc.) may cause palpitations. I recommend to take antacids to see if this relieve your symptoms. This is why I strongly suggest contacting a gastroenterologist to exclude GERD or other gastrointestinal problems. Hope this will be of help! Wish you health! Dr. Shehu