Slow heart rate and palpitations

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I am 43 and have concerns with my heart. I have a VERY slow heart rate. It goes as low as 44 at times. I also get heart palpitations. i do not exercise and I smoke a pack a day. I also have low blood pressure. When I get palpitations I get very scared. I have been told everyone has them and some feel them and some don’t. About 4 years ago I went to the ER and was told I had elevated Troponins and it was thought I had a heart attack. However, I was then told it was mitral regurg stage 3-4 then a month later it was down to a trace and still is to this day. What causes slow heart rate and is there anything I should ask my doctor.


Slow heart rate, palpitations, certainly spell rhythm problems, and with your heavy smoking, I’d certainly be concerned about your heart.
You need have your heart examined as well as the risk factors for developing heart disease. Besides smoking, are diabetes and obesity an issue?

If your slow heart rate is caused by a problem of the electrical conduction system of your heart, you might ultimately need a pacemaker, but with those palpitations your situation might be more complicated.

Thus, you need blood tests, an EKG and probably a 24  hour EKG (Holter monitor), as well as an ECHO of your heart to check that mitral valve to find out it is leaking and, if so, how badly. Women sometimes have a condition called mitral valve prolapse or floppy mitral valve that might apply to your situation;
Your risk for heart disease:
Hope this helps,
Dr T,

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