[18M] Experiencing sudden bradycardia and chest pain

Patient Description

An 18-year-old male reports experiencing sudden bradycardia, with heart rates dropping to 57 bpm from a resting rate of 75 bpm, over the past couple of weeks. These episodes occur mostly at night or when the patient is calm and resting. The patient also experiences slight, sharp chest pain lasting a couple of seconds, sometimes accompanied by palpitations occurring before or after the bradycardia. There are no associated symptoms of dizziness, lightheadedness, shortness of breath, fainting, or swelling in the legs or ankles. The patient recently quit smoking and reports experiencing withdrawal symptoms, including irritability, anxiety, and changes in appetite. No nicotine replacement therapies or aids are being used. The patient maintains a consistent walking routine and consumes a high amount of sugar. The patient's medical history includes asthma and seasonal allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Bradycardia: This is a condition where your heart rate is slower than normal. Since you experience this primarily when resting or calm, it might be a normal physiological response, especially if you are physically fit. However, given the associated chest pain and palpitations, it could also be related to other factors such as changes in your autonomic nervous system after quitting smoking.

  • Nicotine Withdrawal: Quitting smoking can lead to various withdrawal symptoms, including changes in heart rate, palpitations, and chest discomfort. These symptoms can be due to your body adjusting to the absence of nicotine, which previously affected your heart rate and blood pressure.

  • Dietary Factors: High sugar intake can sometimes lead to fluctuations in blood sugar levels, which might contribute to palpitations or changes in heart rate.

  • Other Cardiac Conditions: While less likely given your age and lack of severe symptoms, it's important to consider other cardiac conditions that could cause bradycardia and chest pain. These would typically require further evaluation by a healthcare professional.

What you can do

  1. Monitor Your Symptoms: Keep track of when your symptoms occur, their duration, and any potential triggers. This information can be valuable for your healthcare provider.

  2. Lifestyle Modifications: Consider reducing your sugar intake and maintaining a balanced diet. Regular exercise is beneficial, but ensure it's appropriate for your fitness level.

  3. Manage Withdrawal Symptoms: Since you're experiencing withdrawal symptoms from quitting smoking, consider seeking support from a healthcare provider or support group. They can offer strategies to manage these symptoms effectively.

  4. Use MDandMe: Utilize the MDandMe app to journal your symptoms, track your progress, and gain insights. This can help you share detailed information with your healthcare provider.

What you should look out for

  • Seek Medical Attention: If you experience severe chest pain, shortness of breath, fainting, or any other concerning symptoms, seek medical attention promptly.

  • Regular Check-Ups: Consider scheduling a check-up with your healthcare provider to discuss your symptoms and any necessary tests or evaluations.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and personalized treatment plan.

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1 mo ago

People Also Ask


What is bradycardia and when should I be concerned about it?

Bradycardia is a condition where the heart rate is slower than normal, typically below 60 beats per minute. It can be normal in physically fit individuals, especially during rest or sleep. However, if it is accompanied by symptoms like severe chest pain, fainting, or shortness of breath, it is important to seek medical attention.


Can quitting smoking cause changes in heart rate and chest pain?

Yes, quitting smoking can lead to withdrawal symptoms that include changes in heart rate, palpitations, and chest discomfort. These occur as the body adjusts to the absence of nicotine, which previously influenced heart rate and blood pressure.


How does high sugar intake affect heart rate and palpitations?

High sugar intake can lead to fluctuations in blood sugar levels, which may cause palpitations or changes in heart rate. It's important to maintain a balanced diet to help stabilize these levels and reduce such symptoms.


What are some effective ways to manage nicotine withdrawal symptoms?

Managing nicotine withdrawal can involve seeking support from healthcare providers or support groups, using nicotine replacement therapies, and employing stress-reduction techniques such as exercise, meditation, or deep-breathing exercises. It's important to find strategies that work best for you to ease the transition.


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