Concerns with a low RHR?

[JBar2111]

Hello everyone

I understand that the internet is not the place to seek medical advice, however, I am interested in other people’s opinion and similar experiences. So here it goes.

My name is Juan, I am 26 years old (M).  

A few weeks ago I was at the VA for a checkup, I had an EKG done at my request. The findings were abnormal after reviewing an EKG from the year prior, in comparison. My GP told me I shouldn’t worry unless I was having Chest pain/ SOB and so on. I was sent home feeling nothing but a little anxious. Later that evening I ended up in the emergency room with anxiety and seeking blood work to rule out any cardiac muscle damage(troponin). Blood work and EKG came back normal, the Dr was not concerned but recomended that I see a cardiologist because my EKG was different from just hours prior. “To play it safe”. The next day I saw a cardiologist and he was telling me that my EKG from the prior night was normal. He said that the abnormal EKG from the VA was done incorrectly (leads were too close together.) he said my heart sounded okay and basically he wouldn’t pay for further testing with me. It’s an option though. Went home relieved. This experience has caused me to have heart health anxiety for which I’m doing CBT for. Fast forward a week... I was lying in bed and was convinced I felt my heart flutter after a day for anxiety. I jumped out of bed and painicked. This has caused me to become obsessed with my pulse and basically fear the worst case scenario.

3 weeks ago I would have never noticed anything...

My current resting heart rate is between 43 bpm and 48 bpm. Getting as low as 40-41 just as I’m falling asleep and as I’m waking up. Being an EMT I am well aware of normal rates and all the variables that come with it. Though my RHR is usually in the mid high 40’s I can get up and get a glass of water, sit up straight and see that my pulse then goes up to around 53-65 bpm, 60-90 when I’m walking around or doing chores. I can run up the stairs etc. and get a pulse of 84-100 and within 30-60 seconds come down to my RHR.

I am a former active duty Marine and my life for 4 years involved hiking with a lot of weight, running 1-8 miles a week with hardly any days off. Just a very physical lifestyle. I’m no where near the shape I was in 4 years ago which is why I’m a little concerned with my RHR. The past 3 years now I have been an EMT, my everyday involves complete rest, to running out the door, carrying equipment, lifting people and back to complete rest, a lot of sudden stress. Up until about 3 weeks ago, I was lifting weight in the gym 2-3 times a week, a little woozy after sets or after sometime on a treadmill, only on occasions however. I’m not an athlete level person however I don’t live a sedintary lifestyle.

No major medical HX, at worst I was diagnosed with bronchitis and get a little wheezy after being out in the cold, GERD as well. I get a little woozy now but it feels more like the verge of a panic attack, I feel very relaxed before bed and waking up. I have never fainted, almost did after vomiting too hard post food poisoning (vasvagal) most likely.

I think I am letting my anxiety get the best of me but am curious on y’alls opinion or similar stories. After exerting myself I can feel my heart in my chest pound, that leads to an uneasy feeling of fear for me. Would it be worth getting a stress test or eco? Since this new onset of anxiety my appetite has been sub-par, I lost 10 lbs in 3 weeks. I have been afraid to over exert myself by working out.

I have been a cigarette smoker for years, even through my prime on active duty, I recently quit however. Used to be heavy drinker, haven’t in over a month now. Caffeine intake has dropped quite a bit as well. I’m not sure if my RHR has always been this low or if it’s caused by something in my life. Maybe I’m just noticing this because of my heart health anxiety, but it’s in the back of my head that this could have caused my anxiety, just not sure.

Both parents and siblings are healthy and active.

26 y/o M
V/S as of right now: 57p 128/79 BP 18 RR

[2210485]

Yes all of these tests mentioned in your post are worth it.

A stress test and Holter monitor are gonna be the best places to begin to get an idea as to what your condition looks like.

Thankfully the VA and Military Health system has some of the best Cardiology systems in the country.

This may be suprising but a pretty significant percentage of civilian cardiologists are simply retired military providers. So, while it may be true in many cases that the VA system is lacking; you're in the right system for this type of concern.