What is too low resting heart rate

On this page

  • What is bradycardia?
  • What are the symptoms of bradycardia?
  • What causes bradycardia?
  • When should I see my doctor?
  • How is bradycardia diagnosed?
  • How is bradycardia treated?
  • Can bradycardia be prevented?
  • Related information on Australian websites

Your heart rate, or pulse, tells you how fast or slow your heart is beating. A slow heart rate can be normal, but it could be a sign of a problem. This page explains the difference between a normal slow heart rate and an abnormal one, and what to do.

What is bradycardia?

Bradycardia is a slower than normal heart rate. A normal adult resting heart rate is between 60–100 beats per minute (bpm). If you have bradycardia, your heart beats fewer than 60 times a minute. People who are physically very fit can have a heart rate as low as 40 bpm. But in people who aren’t physically very fit, bradycardia is often a sign of problems with the heart.

What are the symptoms of bradycardia?

A person with a slow heart rate might not be aware of it, but symptoms can include:

  • feeling faint or dizzy
  • shortness of breath
  • feeling tired or weak
  • chest pain or irregular heartbeats

If you have any of these symptoms and you have a slow heart rate, you should see a doctor or go to your nearest emergency department.

What causes bradycardia?

Bradycardia can be due to extreme fitness. But it is often related to other causes, such as:

  • irregular heartbeat or arrhythmia
  • hypothyroidism
  • damage to your heart
  • electrolyte imbalance
  • heart disorder present at birth (congenital heart defect)
  • infection of heart tissue
  • medication, such as those to treat high blood pressure

When should I see my doctor?

If you have a heart rate under 60, and you’re aren’t exceptionally fit, it’s important to see your doctor. It might help to make a note of the times you notice your heart is slow, and how you’re feeling at the time.

FIND A HEALTH SERVICE — healthdirect's Service Finder can help you find doctors, pharmacies, hospitals and other health services.

ASK YOUR DOCTOR — Preparing for an appointment? Use healthdirect's Question Builder for general tips on what to ask your GP or specialist.

How is bradycardia diagnosed?

When you see your doctor, they will measure your heart rate. Your heart rate might have returned to normal, so it’s a good idea to keep a record of when you experience bradycardia or related symptoms.

Your doctor will also need to work out the cause of your bradycardia. They will ask about your symptoms and your medical and family health history, and will examine you. Tests, such as an electrocardiogram, or ECG, might be done to check your heart. Depending on what is found, you might need further tests such as a stress test.

How is bradycardia treated?

Treatment will depend on the cause of your bradycardia. For example if you have hypothyroidism, treating it might bring your heart rate up to normal. People who have a slow heart rate because they are physically fit won’t need any treatment. Some people might need medication, a pacemaker or some other form of treatment for the heart.

Can bradycardia be prevented?

Bradycardia can’t always be prevented. You may help prevent bradycardia by lowering your risk of heart disease. This includes:

  • regular exercise
  • maintaining a healthy weight
  • eating well
  • reducing stress
  • stopping smoking if you smoke
  • keeping blood pressure and cholesterol under control

Bradycardia refers to a slower than normal resting heart rate. Resting heart rate is how fast a person’s heart beats when they are at rest. A person’s heart rate may lower due to age or physical health. Bradycardia can also be a symptom of certain medical conditions.

According to the American Heart Association (AHA), a person’s resting heartbeat is generally between 60⁠ and 100 beats per minute (bpm).

However, people who are physically active or athletic may have resting heartbeats that are as low as 40 bpm. A person’s resting heart rate can also drop during deep sleep. Additionally, a slow resting heart rate can be a result of certain health conditions.

Read on to learn more about slow heart rate, its causes, and treatment options.

A person’s heart is responsible for pumping blood throughout the body. The heart consists of four chambers:

  • right atrium
  • left atrium
  • right ventricle
  • left ventricle

The top two chambers, the atria, receive blood. The bottom two chambers, the ventricles, pump blood from the heart.

Blood has many functions, such as:

  • transporting oxygen and nutrients to tissues and organs
  • creating blood clots to stop bleeding
  • transporting antibodies to fight infections
  • bringing waste products to the kidneys and liver, which then filter and clean the blood
  • regulating body temperature

Learn more about the anatomy of the heart here.

The AHA states that, generally, a resting heart rate of less than 60 bpm means that a person has bradycardia. An individual who has bradycardia may not get enough oxygen-rich blood to certain areas of their body. If left untreated, bradycardia can lead to life threatening complications, such as syncope.

However, a person may naturally have a slower resting heart rate due to physical fitness or age. If an individual is concerned about their slow resting heart rate, they should seek guidance from a doctor.

Sinus bradycardia is a form of slow heart rate that begins in a person’s sinoatrial (SA) node. The SA node is a structure in the top of a person’s right atrium that generates the electrical impulse that starts a heartbeat.

If a person has sinus bradycardia, their SA node is sending the impulses to start a heartbeat but is generating them at a slower rate. This leads to a slower heart rate.

The majority of people who have sinus bradycardia will have no symptoms. Sinus bradycardia can occur in individuals who are physically active or athletic or during deep sleep. However, sinus bradycardia can also develop due to various health conditions, such as heart disease.

Learn more about sinus arrhythmia here.

Junctional bradycardia occurs when the electrical impulse to start the heartbeat begins in the atrioventricular (AV) node rather than in the SA node.

The AV node is a structure at the bottom of the right atrium that can be a pacemaker when the SA node does not function properly.

It is also the location of the pause of the impulse generated from the SA node. This pause provides time for the atria of the heart to finish beating, which causes blood to pool inside the ventricles of the heart. Once the ventricles have filled with blood, the impulse passes to the His-Purkinje system, which causes the ventricles to contract and pump blood out of the heart.

If a person has junctional bradycardia, they may have a problem with their SA node that causes the AV node to take over. Additionally, physically athletic individuals, young children, and people in a deep sleep may also experience junctional bradycardia.

A person can find out their heart rate by taking their pulse.

If a person wants to accurately measure their resting heart rate, they should take their pulse when they are sitting or lying down. A person should also make sure they feel calm and relaxed before checking their resting heart rate.

A person can take their pulse from different locations on their body, including:

  • their wrists
  • the side of the neck
  • the inside of the elbows
  • the top of the feet

Using two fingers, a person can check each of these areas to find where their pulse is easiest to feel. They should not use their thumb to take their pulse, as the thumb has a pulse of its own, and it may therefore interfere with the results.

Once a person has found their pulse, they can count the number of beats they feel over 60 seconds. They may want to set a stop watch or look at a clock while they count their heartbeats.

If a person has a heartbeat count that is lower than 60 bpm, they have bradycardia. Bradycardia does not always mean that an individual has an underlying health condition. However, they should contact a doctor to determine the cause of their bradycardia.

Children and young people have more rapid heart rates than adults. A normal heart rate for an infant is around 140 bpm, whereas an older child or teenager should have a resting heart rate of about 70 bpm.

Learn more about what a healthy heart rate can look like here.

A person may experience mild bradycardia, or only have symptoms from time to time. If they notice that they have a slow heart rate, they should speak with a doctor to determine the cause.

Bradycardia will not always require treatment. If a person does not have any other symptoms and has a structurally normal heart, their bradycardia may be due to an additional factor, such as physical fitness.

People who engage in high amounts of physical activity tend to have more efficient hearts. This may slow their pulse, because their heart does not have to pump as hard or as fast to supply blood to the rest of the body.

Certain medical conditions can cause bradycardia. These conditions include:

Sick sinus syndrome

Sick sinus syndrome, also known as sinus node dysfunction (SND), is a condition that affects a person’s SA node, causing it to fire impulses at irregular rates. This can mean a person’s heart rate speeds up, slows down, or does a combination of both.

Other symptoms of SND include:

  • palpitations, where a person’s heart feels like it is fluttering, pounding, or pausing
  • tiredness
  • lightheadedness
  • feeling faint or fainting

Although SND can develop in people of any age, the average age of someone who has it is 68 years old. SND is a common cause of bradycardia.

Other heart electrical issues

If the heart is unable to send electrical signals due to a blockage or heart disease, this can lead to bradycardia.

Complete heart block is when there is a total loss of communication between a person’s atria and the ventricles. This occurs when the SA node is unable to pass a signal to the AV node.

Complete heart block results in a person’s atria and ventricles activating independently of each other. If a person does not receive treatment for complete heart block quickly, it can be fatal.

Metabolic problems

Some metabolic disorders can slow the heart rate. One of the most common is hypothyroidism, which is when the thyroid gland does not produce enough hormones. Hypothyroidism can affect the health of the blood vessels, which may slow the heart rate.

Thyroid disorders are common and may affect young and otherwise healthy people. Between 4 and 10% of individuals in the United States have hypothyroidism.

Other metabolic conditions that can cause bradycardia include:

  • acidosis, a condition where there is too much acid in bodily fluids
  • hyperkalemia, where a person’s potassium levels are too high
  • hypokalemia, which is when a person’s potassium levels are too low
  • hypothermia, which happens when the body temperature becomes too low

Heart-damaging conditions

Damage to the heart due to certain conditions can cause it to pump more slowly and less effectively. Conditions that can damage the heart include:

  • congestive heart failure
  • coronary artery disease
  • heart attack
  • myocarditis, which is inflammation of the heart muscle
  • Lyme disease
  • thickened heart muscle
  • hypertension
  • diabetes

Heart medication

Certain medications, including medications for heart disease and high blood pressure, may lower heart rate.

Beta-blockers or calcium channel blockers, which doctors prescribe for a rapid heart rate and some other heart conditions, may also slow heart rate.

Individuals taking a new medication who experience symptoms of bradycardia should contact a doctor.

Oxygen deprivation

Hypoxia is a term that health experts use when a person is unable to get enough oxygen to the tissues of their body. Hypoxia is a medical emergency, and it can occur when a person is choking or having a severe asthma attack. Chronic medical conditions, such as chronic obstructive pulmonary disease, may also cause hypoxia.

If hypoxia lowers a person’s heart rate, it is essential to treat the underlying cause.

If a baby has a low pulse, a parent or caregiver should take them to the emergency room.

Adults and children who have a low pulse and experience symptoms such as chest pain, fainting, or exercise intolerance should also go to the hospital.

A person should contact a doctor about bradycardia when they:

  • experience an unexplained change in heart rate that lasts for several days
  • have bradycardia and other heart health risk factors, such as diabetes or smoking
  • have heart disease and bradycardia
  • experience bradycardia and other symptoms, such as fainting spells
  • experience episodes of bradycardia and tachycardia, which is a rapid heartbeat

If a person is concerned about their slow heart rate, they should also consult a doctor.

A doctor may not always need to treat a slow heart rate. However, when a slow heart rate causes serious health problems, it is essential that a person receives treatment.

The treatment an individual receives for their bradycardia will depend on the underlying cause. A doctor may use certain tests to diagnose the cause of a person’s bradycardia. These tests include:

  • physical tests
  • questions about medical history
  • blood tests
  • heart monitors
  • imaging tests

If a person has a condition that interferes with the electrical impulses of their heart, they may require a pacemaker. This is a device that is implanted under a person’s skin and connected to their heart. The pacemaker then sends impulses to the heart that cause it to beat regularly.

Depending on the cause, a doctor might also recommend:

  • changing heart medications
  • taking medication to treat thyroid or other metabolic disorders
  • making lifestyle changes, such as eating a low fat diet, getting more exercise, or quitting smoking
  • monitoring heart rate or blood pressure frequently

Learn how a person can check their own blood pressure here.

Heart disease can be fatal, so it is crucial that a person take any changes in heart health, blood pressure, or pulse seriously.

However, a slow heart rate is not always a cause for concern. Bradycardia can sometimes be an indication that a person is in good physical condition.

Only a doctor can evaluate a person’s cardiovascular risk factors. If an individual is concerned about their slow heart rate, they should consult a doctor.

Read the article in Spanish.

Is 40 bpm too low when sleeping?

Average Heart Rates While Sleeping During sleep, it is normal for a person's heart rate to slow down below the range for a typical resting heart rate. Between 40 to 50 beats per minute (bpm) is considered an average sleeping heart rate for adults, though this can vary depending on multiple factors.

Is a resting heart rate of 50 too low?

The normal range is between 50 and 100 beats per minute. If your resting heart rate is above 100, it's called tachycardia; below 60, and it's called bradycardia. Increasingly, experts pin an ideal resting heart rate at between 50 to 70 beats per minute.

What is the lowest acceptable heart rate?

Slow Isn't Always Bad A slow resting heart rate is known as bradycardia, which occurs at 60 beats per minute (bpm) or less, even when active. In contrast, a normal resting heart rate will fall in a range between 60 – 100 bpm.