Will having a low heart rate be a problem when going under general anesthesia?

Question

Will having a low heart rate be a problem when going under general anesthesia? My blood pressure is normal but my resting heart rate is always under 60, but never below 40. Is this something I should be worried about?

Thomas Buonassisi, MD · Answer

Having a low resting heart rate, known as bradycardia, may not be an issue on its own when going under general anesthesia, especially if your blood pressure is normal and you have no other heart-related symptoms. A resting heart rate under 60 can be normal for some individuals, particularly those who are physically fit. However, it's important to inform your anesthesiologist about your heart rate so they can monitor you closely during surgery. They will assess your overall heart function and tailor anesthesia management to ensure your safety during the procedure.

Ali Sajjadian, MD, FACS · Answer

Thanks for your question .Depending on the situation, a low heart rate during general anesthesia could be problematic. No particular heart rate is generally regarded as dangerous for general anesthesia. A heart rate below 60 beats per minute (bpm) can be normal for some people, especially athletes or those with a strong vagal tone.
Your heart's reaction to the anesthetic and any underlying medical issues are what matter. In and of itself, a low heart rate isn't always an issue, but if it falls too low or is accompanied by other problems, like low blood pressure, it may be cause for concern.
In order to maintain stable vital signs throughout surgery, anesthesiologists are trained to keep a careful eye on patients and modify medicine as necessary. They can take action to raise your heart rate if it falls too low.   
Being open and honest with your anesthesiologist is essential to a safe anesthesia treatment. Make sure to share your prescriptions, medical history, and any worries you may have.
However, during general anesthesia, even a baseline low heart rate can become a concern, especially if it drops further. To minimize risks, it's crucial to:
Let Your Anesthesiologist Know: Tell them about your low heart rate, any underlying medical concerns, and any medications(prescribed or supplement type medications) you are taking.   
Preoperative assessment: To determine any possible hazards and gauge your general health, the anesthesiologist will do a comprehensive assessment.   
Close Monitoring: Throughout the procedure, the anesthetic staff will keep a careful eye on your vital signs, including your heart rate.
Hope this was helpful!
Best wishes,
Dr Ali Sajjadian 
TRIPLE Board Certified Plastic Surgeon

Jeffrey Lisiecki, MD · Answer

If your heart rate is low because you're young and fit, and your blood pressure is normal without any symptoms of low blood pressure, usually that is not a problem with general anesthesia.  Definitely discuss this with your surgeon and anesthesiologist, though.  I always have patients get a preoperative clearance from their primary care doctor to ensure that they don't have any underlying health problems or anything specific we need to be worried about!

Carey Nease, MD · Answer

As long as you are healthy then there should be no problem with your heart rate being below 60. This is common in young people who are very athletic (distance runners, etc). Check with your PCP if you have any doubt and talk with the planned anesthesia provider ahead of time also! Good luck!

Mark K. Markarian, MD, MSPH, FACS · Answer

Hello Michelle and thank you for your question.

A low heart rate is often seen in healthy, athletic individuals.  However, it can sometimes be associated with cardiovascular issues.  In my practice, I always have patients cleared by their primary care physician, and in the case of possible cardiac issues, a cardiology clearance is also necessary.  The anesthesiologist at the hospital would also have to clear you in the pre-hospital screening process and before surgery.

With proper preoperative precautions as above, your heart rate is unlikely to be a significant issue, but you should always be safe and address this well in advance with your plastic surgeon, your primary care physician (and possible cardiologist), and the anesthesiology team.

For more information on rhinoplasty, please refer to my link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS
Harvard-trained Board Certified Aesthetic Plastic Surgeon

Caner Kacmaz, MD · Answer

Thank you for your question. A lower heart rate doesn't necessarily cause an issue for the surgery. EKG is included in our pre-checkups to eliminate any problems and give us peace of mind. Although we check your heart before the surgery, we also recommend a clearance form from your primary care physician. Thank you and good luck.

Gianfranco Frojo, MD · Answer

A low heart rate is not uncommon, especially in very healthy individuals. This is also common in patients that exercise a lot. I would ask you primary care doctor to do an evaluation and potentially an electrocardiogram to ensure that there are no structural heart problems that would be causing a slow heart rate.

George Bitar, MD · Answer

There are many causes for a slow heart rate, including a heart issue, underactive thyroid gland, abnormal electrolytes, and medications.  The cause of the low heart rate could impact general anesthesia.  You should see your primary care physician for further evaluation.  They would likely start with a blood draw to check your labs and an electrocardiogram or EKG to ensure that signals that control the heartbeat are normal.  They would also need to know if the slow heart rate is causing you symptoms.  For example, you may have difficulty exercising, dizziness, fatigue, chest pain or shortness of breath.  Hopefully that gives you a starting point to discuss with your physician.

Robert Ciardullo, MD · Answer

Low heart rate and anesthesia:There are many causes of a low heart rate. In young healthy people, the most common cause is being in extremely good cardiovascular conditioning from running several miles a week. A low heart rate if not caused by good conditioning could be due to abnormalities of the heart and its conduction system. A slow heart rate will often get even slower during anesthesia. I have seen patients with resting heart rates of 60 due good conditioning get down into the 40s during surgery and in recovery. This can usually be addressed with medication‘s which raise the heart rate , so I have never seen it be a problem in a healthy young person. In someone who has a low heart rate due to heart disease, the course may be not so simple. Such a person should have a thorough cardiovascular evaluation with a cardiologist prior to considering anesthesia. Some medication such as beta blockers are notorious for causing very low heart rates, and there are multiple medical and cardiovascular conditions which could also result in low heart rate. Once again these should be evaluated by a cardiologist prior to considering anesthesia.

William Portuese, MD · Answer

Best to check with your primary care physician and get an EKG make sure there's not a underlying problem with your heart. Make sure you show that ahead of time to your surgeon and anesthesiologist.

Will having a low heart rate be a problem when going under general anesthesia?

Answers (11)

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