Is a pulse of 50 too low

Key takeaways:

• Low heart rate, or bradycardia, is a heart rate below 60 beats per minute. But a low rate is not always a sign of a problem.

• Bradycardia is often not a cause for concern when it is not causing any symptoms. And it can even be a sign of good cardiovascular fitness that allows the heart to pump more efficiently. 

• There are some symptoms and circumstances you can look out for to know if you should see a provider for your low heart rate. 

With smartwatches and fitness tracking devices gaining in popularity, people are aware of their minute-to-minute heart rate more than ever. Sometimes, you might notice that your heart rate seems a little slower than normal. 

Bradycardia is the medical term for a heart rate under 60 beats per minute. While there are times that bradycardia can be a sign of something serious going on, often it’s not something to worry about. This is especially true for people who are young and healthy with no other symptoms. 

In fact, bradycardia can be a sign of good physical fitness. We’ll review when a low heart rate is normal and healthy, and how to know if it is a cause for concern. 

What are the harmless causes of low heart rate?

It is normal for our heart rate to fluctuate throughout the day. It naturally changes in response to what our body needs and what we are doing. Some harmless causes of bradycardia include: 

• Sleep: Our heart rate is generally lower when we are asleep or in a relaxed state. This is also known as our resting heart rate. When we are lying down and resting, our heart doesn't have to work as hard against gravity to get the blood everywhere it needs to go. When we’re sleeping, our bodies don’t use as much energy, so our nervous system tells the heart to take a little bit of a break.  

• Physical fitness: Cardiovascular activity strengthens our heart muscle. And a stronger heart can pump blood more efficiently. When the heart beats more efficiently in someone who has been physically training over time, their heart rate tends to be lower. 

• Certain medications: Some medications lower the heart rate in order to decrease the amount of work the heart has to do. Some examples include blood pressure medications, like beta blockers or calcium channel blockers. 

While these causes of bradycardia are expected, there are some concerning conditions that can also cause a low heart rate.

What other conditions cause a low heart rate?

Many of the medical conditions that cause bradycardia are more common in people who are older or have underlying heart conditions. Some examples of medical problems that can cause bradycardia include:

• Problems with the heart’s electrical pathways: There is a special electrical circuit in our heart that controls each heart beat. Problems with this conduction system can cause the signal to go awry. This is called an arrhythmia. 

• An abnormal shape or structure of the heart: The shape and size of the heart can begin to change in response to other medical problems. Examples include high blood pressure, coronary artery disease, or heavy alcohol use. Some people are born with certain defects, too. All of these conditions can affect the conduction system we just mentioned.  

• Metabolic abnormalities: The heart requires the right balance of electrolytes and hormones to pump correctly. Conditions like hypothyroidism or low potassium levels can cause the heart to beat too slowly.

When to worry about a low heart rate

When a drop in your heart rate is natural and harmless, it doesn’t cause any symptoms. But if you also have one of the following symptoms, it could be a sign that something else is going on: 

• Dizziness or lightheadedness

• Fainting

• Palpitations or a sensation of skipped heartbeats

• Chest pain

• Shortness of breath

• A new difficulty in your ability to exercise or exert yourself

• Excessive fatigue 

But more concerning bradycardia doesn’t always cause symptoms. Even if you don’t have any symptoms, it’s a good idea to talk to your healthcare provider if you have new bradycardia and one of the following conditions: 

• Age over 50 years old

• Heart disease 

• Kidney disease

• A history of electrolyte abnormalities 

• Thyroid problems

• A heart rate below 40 beats per minute

There are some simple and easy tests that your provider can do to figure out if your heart rate is a problem. These can include an electrocardiogram (ECG) and echocardiogram (an ultrasound of the heart), or blood tests if your provider suspects a thyroid or electrolyte problem. Your provider may also recommend you wear a small heart monitor for a few days, which can monitor your heart beat 24/7.

The bottom line

In young and healthy people, bradycardia is most often a sign of good cardiovascular health. And when this is the case, bradycardia does not cause any symptoms. When new changes in your heart rate are a sign of something else is going, they are often accompanied by new symptoms as well. These can include shortness of breath, chest pain, dizziness, fainting, or extreme fatigue. 

If you are worried about your heart rate, or experiencing any of these symptoms, it is best not to delay medical evaluation.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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