Slow heart rate with exercise?

[Guspuppy]

I have pvc's, have had them all my life I think, starting when I was about 12. (I am 54) A few months ago I was driving home from a long day trip when I felt like I was about to pass out. I pulled off to the side of the road and called my cousin, who is an ER nurse. After talking with me for a few minutes she told me to hang up and call 911, which i did. The 'about to pass out' feeling lasted roughly 30 minutes, and the ER doc found a heart murmur I never knew about. He advised a follow-up echo when I got home. I had the echo and it was normal. My pcp dr wanted a 24-hr holter as well, which showed pvc and some runs of bigeminy. She has a consult in to cardiology but I haven't heard from them as yet. All this heart focus has had me stressed out and paying way more attention to what my heart is doing, which I know is bad for it. My pvcs became very prevalent to my notice, esp while I was working at my very physical job.

I was freaked out by the pvcs at first, but then I quit caffeine and they became much less noticeable. But now I am a little stressed because my heart sometimes seems to beat WAY too slow for my perceived effort. Yesterday I went on a long hike and during the first big uphill portion my fitness tracker said my heart rate was only ~85. It was definitely slow, and very strong heartbeats which i could feel in my chest. Presumably pvc with compensatory beats. Maybe bi- or tri- geminy? Later as I kept hiking my heart rate went to a more normal speed and in fact maybe went the other way as it got to 161 on a downhill part.

Agh! I think I am probably freaking out about nothing, I have read a lot in these forums and know that hormones (i am peri-menopausal), thyroid, electrolyte imbalance, vitamin and mineral deficiencies, vagus nerve irritation, pretty much anything can cause pvcs to become more frequent and/or noticeable. I'm just really looking for anyone else who seems to have a really slow heart rate during exercise due to their pvcs! Also often when I sit down for a few minutes my HR will drop to like 42 according to my fitness watch. (Also while sleeping sometimes)  The holter didn't catch any of that bc it was super hot the day I wore it and heat is hard on me. I've had this fitness watch for less  than a year. I am beginning to think being able to see my HR all the time (and so worry about if it is normal or not) is not such a great thing!

[MichelleP_3811]

If you feel you are hyper focused on your heart to the point it's distracting it may be best to not wear the watch.  The main thing with the heart is more about how you feel than the rate the heart is beating at.  When we exercise consistently we condition our hearts and they will beat slower on average.  So it's more about whether you were also having concerning symptoms with the heart rate changes.  The fact you felt like you would pass out is a concern.  that doesn't necessarily mean it was due to your heart.  It could be low blood sugar, dehydration, electrolyte imbalance or something else that triggers the heart to beat too fast or too slow that can make us feel faint.  Unfortunately you may never know exactly what your heart was doing when you felt like you would pass out.  It may not have even been your heart, it could have been blood pressure or  it could have been some sort of heart rhythm abnormality but unless it was caught on a monitor then one can't say for sure.  If your heart was back to normal by the time you were hooked up to a monitor you will never know. that is the biggest issue with diagnosing heart rhythm issues.  They are generally unpredictable.  Considering you had an echo done and your heart was evaluated to be normal and healthy odds are that whatever your heart is doing isn't of great concern.  If you have repeated episodes of feeling faint then I would suggest that you request a 30 day monitor.  Especially if they start to happen at least once a month.  That way you can catch what it is on a heart monitor and have it properly diagnosed.  But if you aren't having any respiratory issues with your heart beating fast, slow or skipping around then it really won't be a concern for a cardiologist.   So I'd say just try and keep note of any concerning symptoms that arise and try to not hyper focus on the exact rate your heart is beating at.  And try to rest assured that with a healthy echo that likely means your heart will handle anything that is going on without any major issues.  If anything concerning happens again contact your doctor otherwise try and trust your heart.  Take care.