What should I do if my heart rate is below 50 and what medicine should I take

Sinus bradycardia with a heart rate below 50 beats per minute can be intervened with drugs such as atropine, isoproterenol, theophylline, etc. It is usually caused by high vagal tone, myocardial ischemia, hypothyroidism, drug side effects, or electrolyte imbalances.

1. Vagus nerve excitation:

Long term exercise training, sleep, or gastrointestinal stimulation may trigger physiological vagal nerve overexcitation, leading to a decrease in heart rate. This type of situation usually does not require medication and can be improved by reducing caffeine intake and avoiding breath holding movements. If accompanied by fainting, temporary cardiac pacing should be considered.

2. Insufficient myocardial blood supply:

Coronary artery stenosis or myocarditis may cause sinus node dysfunction, and electrocardiogram often shows ST segment changes. In addition to drugs such as nitroglycerin to improve blood supply, patients with severe sinoatrial node lesions may require permanent pacemaker implantation.

3. Thyroid dysfunction:

Thyroid hormone deficiency can reduce the excitability of myocardial cells, and laboratory tests show an increase in TSH and a decrease in FT4. It is necessary to supplement with levothyroxine sodium and monitor the changes in resting heart rate in the morning.

4. Drug factors:

Excessive use of beta blockers such as metoprolol, digoxin, or calcium channel blockers may inhibit cardiac autonomy. The dosage should be adjusted under the guidance of a doctor, and dopamine antagonists should be used if necessary.

5. Electrolyte imbalance: Severe hypokalemia<3.0mmol/L or hyperkalemia>6.0mmol/L can affect cardiac conduction, requiring intravenous supplementation of electrolyte solution and continuous electrocardiographic monitoring.

In daily life, sudden changes in posture should be avoided to cause orthostatic hypotension, and elastic socks can be worn to improve venous return. It is recommended to engage in 30 minute aerobic exercises such as brisk walking and swimming three times a week, with a heart rate controlled within a safe range of 220% -50% of age. Pay attention to supplementing magnesium rich nuts and dark green vegetables in your diet, and limit the intake of high-fat foods. Regularly monitor the morning heart rate and record changes in symptoms. If severe symptoms such as blackout and transient loss of consciousness occur, immediate emergency treatment is required.