Diagnosis
Bradycardia

The two most common causes of bradycardia are abnormalities with the heart’s natural pacemaker or electrical system. The sinoatrial (SA) node is the heart’s natural pacemaker. It creates electrical impulses to stimulate the heart and the atrioventricular (AV) node sends those impulses to the lower chambers of the heart. In bradycardia, there is a disruption in the impulses either at the nodes or along the electrical relay.

Many other conditions or diseases may result in bradycardia, including:

  • Aging

  • Amyloidosis

  • Autoimmune problems

  • Autonomic reflexes

  • Collagen vascular disease

  • Congenital heart defect

  • Coronary artery disease

  • Diphtheria

  • Drug abuse

  • Dysfunction of the sinus node

  • Electrolyte imbalance

  • Endocarditis

  • Heart attack

  • Heart disease

  • Hemochromatosis

  • Hypoglycemia
  • Hypothermia

  • Hypothyroidism

  • Infectious diseases

  • Inherited diseases

  • Lupus

  • Medications like beta-blockers or digoxin

  • Myocarditis

  • Muscular dystrophy

  • Neurologic disorders

  • Prolonged bed rest

  • Reduced blood flow to the heart

  • Rheumatoid arthritis

  • Rheumatic fever

  • Sarcoidosis

  • Scleraderma

  • Surgical trauma

To help your doctor diagnose your bradycardia, you may consider keeping a symptom diary. In your diary, you should note everything possible about your symptoms when you experience them. For example, what symptoms did you experience? What time of the day did you experience the symptoms and how long did they last? What were you doing when your symptoms began? When you experience symptoms, try to take your pulse for a minute and note these findings in your diary too.

Be sure to take your diary with you when you visit a cardiologist. A cardiologist is a doctor who specializes in the treatment of heart-related problems.

The cardiologist will review your medical history and perform a physical examination. He or she will perform a series of tests to make an accurate diagnosis. The tests may include:

  • Electrocardiogram (EKG or ECG)
    This is the most important diagnostic test for bradycardia. An EKG can also tell you if you’ve had a recent heart attack or if you have other heart conditions. Unfortunately, an EKG will only be able to detect bradycardia if you experience symptoms during the test.

  • Ambulatory EKG (also known as a Holter monitor or cardiac event monitor)
    If your bradycardia symptoms come and go, it may be necessary for you to use an ambulatory EKG. This type of EKG is a lightweight device that you wear throughout the day. Pads attached to your chest will record your heart beat continuously.

  • Blood tests

  • Stress test
    Bradycardia is often worse when you exercise. During this test, you will be asked to exercise on a treadmill or stationary bicycle, while an EKG monitors your heart.

  • Echocardiogram
    An echocardiogram allows your doctor to measure your heart’s blood volume, and the speed and direction of blood flow. You will be asked to wear a small device on your chest that emits sound waves that will bounce off of your heart. The waves produce videos of your heart that your doctor will analyze.




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