Bradycardia in athletes – is it possible to play sports, in children, sinus

Bradycardia is called a slowdown in the rhythm of the heart, negatively affecting the body. With bradycardia, the number of heartbeats becomes less than 60 within a minute. Such a change in heart rate occurs sinusally, under the influence of pulsed electrical discharges that are generated by the heart muscle (myocardium).

One way or another, when playing sports, the heart muscle increases in size. However, a healthy human heart only grows so that it can work at increased loads with maximum savings. This increase has limits that are safe for the body and, in the absence of constant loads, the myocardium returns to its original or close state. How is cardiac muscle growth achieved without negative consequences for the heart and the body as a whole?

First of all, the work of a normal, well-functioning “sports heart” is characterized by a heart muscle contraction rate of at least 60 for a minute, while ensuring normal blood flow, freely covering all organs. As for the size of the heart, the range of its physiological changes is always within certain limits. Too large a heart, the volume of which exceeds 1200 cubic centimeters, threatens the transition of the physiological state to pathology.

Many people falsely classify people leading an active lifestyle and playing sports as healthy.

In medicine, this phenomenon was called the “sports heart” and was attributed to the category of serious diseases of the cardiovascular system.

For an athlete, this is an acquired heart as a double-edged sword. On the one hand, it has a developed and hardy heart muscle, and on the other hand, almost irreversible pathological processes occur in it.

The classification of “sports heart” directly depends on a particular sport. Athletes, swimmers, climbers, cyclists and skiers have an increased ventricular volume and a slight increase in the thickness of the muscle wall.

This leads to obstruction of pulmonary circulation. In order for the heart to overcome the resistance in the vessels and push the blood flow into them, it is forced to contract more intensively. Therefore, its muscle mass is gradually increasing.

  • If an athlete does not train in accordance with the program developed for him by a professional trainer, or he often suffers colds, chronic infections, then pathological processes will begin to develop in the heart muscle.
  • A sports heart that has undergone pathological changes is greatly increased in volume and can reach up to 1700 cubic centimeters.
  • Its performance decreases in all respects, since myocardial hypertrophy leads to destabilization of blood flow, oxygen starvation of some fibers of the heart muscle, and in critical situations to necrosis, which is diagnosed as myocardial microinfarction.
  • Subsequently, dead fibers are replaced by connective tissue and form cardiosclerosis. Such changes extremely negatively affect the work of the pathological heart.
  • Doctors cannot draw a parallel between the degree of development of bradycardia and the degree of preparedness of the athlete.
  • Some patients involved in sports are not sufficiently adapted to the loads, have low working capacity, quickly tire, suffer from insomnia and other symptoms. Such athletes should immediately be examined, in particular, if the heart rate is 40 or less beats per minute.
  • From this we can conclude that bradycardia and sports have a direct relationship. The goal of sports physicians is to monitor changes in the cardiovascular system of athletes, to study pathologies that manifest themselves and to find a dangerous diagnosis of a sports heart.
  • In the case when a professional athlete carefully listens to the recommendations of the trainer and performs loads and cycles exactly, his heart trains in a natural way and provides him with high endurance and performance.
  • The advantage of a physiological sports heart is that it is able to function extremely economically in a state of rest and take maximum loads during overvoltages.
  • If we talk in more detail about the economical mode of the heart, it is understood that the heart rate can drop below a stable mark of 60 beats, but at the same time, full circulation in the body is maintained.
  • The missing amount of oxygen and nutrients is carried to the organs through a network of additional blood vessels (capillaries) developed through training, which are suitable in close proximity to the heart.
  • Athletes who have developed a physiological sports heart should be constantly monitored by their doctor. The magnitude of the increase in heart muscle should not exceed 1200 cubic centimeters. Everything above this indicator develops into a pathological type of sports heart.
  • Physiological sports heart threatens with an instant transition from the state of bradycardia to tachycardia from the first seconds of training. After half a minute, the athlete’s pulse can be 160-240 beats per minute, that is, increase 2-5 times.
  • After a critical peak, the body readjusts to the load and adapts to the energy needs of the body. At the end of the workout, the heart rate quickly returns to normal.

Regardless of the category of sports heart in an athlete, he will need constant medical supervision. If there is a risk of moving from one stage of bradycardia to the more difficult one, the attending physician may prescribe the athlete a reduction in the degree of exertion or a complete rejection of them.

The mechanism of development of bradycardia

The manifesting signs of bradycardia can be either the primary source of the pathology, or a consequence of diseases previously transferred to the patient. For one patient, this condition is acceptable, but for a person in a pre-infarction crisis is deadly.

Another term for this phenomenon is a local power station. It is she who is responsible for generating pulses with a given frequency, which the body needs at this stage for adequate functioning.

The sinoauricular node (CA node) located in the right atrium directs the entire process. This node stimulates the heart muscle to contract 60 times per minute.

If oxygen demand increases under loads, then the CA site begins to work more intensively.

These centers are not able to stimulate impulses with the required power, as a result of which the patient develops bradycardia of the heart.

Regular physical training leads to a thickening of the muscle fibers of the heart, which requires a more intensive supply of oxygen for them. In such a situation, the work of the heart is compensated by tachycardia. But with a further thickening of the heart muscle, a compensatory branched vascular network develops in it, which is able to supply the heart with blood in full even with more severe loads.

With such a constructive modification, an increase in heart rate is irrational, and athletes develop sinus bradycardia – a noticeable decrease in the rhythm of the heart. The heart switches to an economical mode of operation: more rare, but more powerful contractions. With an increase in physical activity, the pulse increases from 2 to 5 times. After reducing the load, it comes to its original state. A heart that can work in this mode is called physiologically sports.

It provides normal blood supply to all organs and systems, normal vital functions of the body as a whole.

If the heart grows too intensely, then a pathological sports heart develops, for which such signs are characteristic:

  • low heart rate;
  • weak muscle contractility of the heart;
  • high hypertrophy of the heart muscle;
  • change in the conductivity and rhythm of the heart muscle;
  • replacement of muscle fibers with connective tissue, which leads to cardiosclerosis and functional heart failure.

Causes of deviations

Heart rate disturbances or cardiac arrhythmia are associated with heart rate. Physiologically low heart rate is often found in athletes (including former) and indicates a stronger heart that can pump more blood.

Causes of heart rate abnormalities include bradycardia, in which the heart rate slows down. This disorder can be caused by a heart attack, intracranial damage used by the medicine. The opposite is tachycardia, in which the heart rate increases.

Safe sports

Whatever sport a person chooses, all of them will positively affect the heart only under conditions of competent loads and the absence of background cardiac pathologies. But it is worth noting that the size and development of the heart muscle will be different depending on what kind of sport a person is engaged in. Thus:

  • Minor differences are recorded in heavyweight athletes.
  • A little more developed heart with a passion for different types of wrestling, hockey, football, basketball.
  • The heart is well developed among people engaged in speed sports – runners, cyclists, skiers.

A healthy lifestyle can take any form, but walking is considered the best exercise in bradycardia. She can be treated for most diseases, including joint problems and obesity. Regular walks strengthen the heart, activate blood flow, increase endurance. To achieve this result, start with 10-minute walks and slowly increase their duration.

Fitness exercises in the water are also a great option. Water aerobics has a gentle effect on the body, which makes it an optimal occupation for unprepared people. If you do not want to buy a subscription to a group, just regularly visit the pool, swimming will be remembered for one training.

Cycling has a good effect, but it requires a vehicle and minimal handling skills. If desired, you can replace the bike with a simulator, which is installed at home and used in any weather. At the first stages, it is enough to train for 10 minutes several times a week, gradually developing endurance and adding 5 minutes to the duration of the training.

How does bradycardia develop in athletes

Normally, the heart rate in an adult is in minutes. If the number of contractions is in a smaller range, then this is bradycardia. More than normal parameters are called tachycardia.

Hockey, swimming, wrestling are less dangerous regarding the development of bradycardia.

Interesting! Weightlifters practically do not suffer from bradycardia, since the specificity of training does not affect the myocardium and does not affect the heart rate.

What is the danger of bradycardia for adults and children

Moderate severity of bradycardia does not lead to a significant decompensation of hemodynamics. But if the number of contractions drops to 40 beats per minute, then the following clinical signs develop:

  • general weakness;
  • fainting conditions;
  • difficulty breathing
  • decreased vision;
  • pain in the chest;
  • decreased ability to concentrate;
  • convulsive syndrome.

The brain is the most sensitive to oxygen starvation, with the cessation of blood flow, attacks of loss of consciousness develop, if help is not provided in a timely manner, then respiratory and cardiac activity stops.

Signs of bradycardia can occur at different ages, starting from birth. Children who have bradycardia of various etiologies should be monitored by pediatricians and pediatric cardiologists. Causes of bradycardia in children can be inherited and acquired factors. As in adults, it can be pathological and physiological in nature.

Physiological bradycardia does not need correction, but the child should be constantly monitored by parents and doctors. The decrease in heart rate is due to sports, active games and other activities (sports dancing, circus studios, etc.). This condition is adaptive to prolonged and systematic physical exertion.

Symptoms of pathological bradycardia are invisible for a long time. She begins to show herself with unconditioned weakness, constant fatigue, drowsiness, and dizziness. The child may faint during class. Symptoms of bradycardia are shortness of breath, inability to withstand the usual loads in physical education classes, cold sweat, pallor of the skin. Such symptoms can not be ignored, it is necessary to examine the child with a cardiologist.

With pathological bradycardia in children, specialized cardiological care is needed. Accessible sports are possible only after treatment and rehabilitation, with the recommendations of the attending physician.

Cardiologists have no unequivocal opinion about bradycardia among athletes – can they continue to engage in intense sports? The reason for this disagreement is the facts of the sudden causeless death of athletes from acute heart failure. Therefore, for professional athletes, recommendations of the Ministry of Health and Social Development have been developed, in which the main provisions are preventive measures to identify pathological bradycardia in athletes and their removal from training in order to provide adequate treatment.

Symptoms of bradycardia and features of its treatment

Bradycardia is a type of arrhythmia and is characterized by a low number of heart contractions. This diagnosis is made if the heart rate is less than 60 beats per minute. It should be said that such a heart rate is produced in athletes as a result of adaptation to high physical exertion and is the norm and a sign of fitness.

Bradycardia as a disease is said to be when there are pathologies in the cardiac conduction system and abnormalities in the work of the cardiac pacemaker are observed. At the same time, the myocardium cannot work fully and provide organs and tissues with blood, and therefore nutrition. Severe illness can be life threatening.

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Types of bradycardia

There are several varieties of bradycardia:

  1. Absolute. It is always determined, regardless of the condition of the person and the conditions in which he is.
  2. Relative. This type of bradycardia occurs with injuries, as a result of physical activity, with infectious diseases, with hypothyroidism.
  3. Moderate. It occurs mainly in adolescents and children, as well as in people with respiratory arrhythmia and with a high tone of the autonomic nervous system. At the same time, when you inhale, the pulse quickens, and when you exhale it becomes rare.
  4. Extracardial bradycardia. It develops in people with neurological pathologies, diseases of internal organs.

Localization distinguishes such species as sinus bradycardia (the rhythm source is the sinus-atrial node), as well as the sinoatrial and atrioventricular, arising from impaired conduction between the atria and / or ventricles and the sinus node.

For reasons of development, bradycardia is divided into idiopathic, toxic, central and degenerative.

Signs of bradycardia

Symptoms depend on the duration and severity of the disease and are expressed by the following manifestations:

  • Constant fatigue, weakness and weakness, while not even a full sleep can save. Semi-fainting and fainting conditions are possible. Such symptoms are associated with a decrease in blood pressure.
  • High fatigue even with light loads.
  • Persistent dizziness.
  • Cold sweat.
  • Labored breathing.
  • Pressing chest pains and “trembling” of the heart.
  • Lightheadedness, darkening in the eyes.
  • Stray, difficulty concentrating and focusing.
  • Blood pressure with sinus bradycardia can be unstable: it rises, then falls.
  • Physical work is difficult.

Manifestations of bradycardia adversely affect the quality of life. Often there are sudden attacks – Morgagni-Adams-Stokes syndrome. After 20 seconds, muscle cramps appear, the pulse becomes very rare or absent, deep breathing, the skin is pale. An attack can end in death.

With bradycardia, the brain is not adequately supplied with blood. In severe forms of the disease, symptoms may appear from the myocardium and brain. In addition to fainting, there is an instability of blood pressure, cardiac ischemia, rest angina and tension, heart failure, cardiac arrest is possible.

How is the diagnosis made?

Preliminary diagnosis is based on a survey of the patient himself. From his words establish the severity and duration of the disease.

The diagnosis of sinus bradycardia is being clarified using a series of examinations. One of the most effective methods is an ECG. At the same time, electrical impulses are measured that control the heart rate. You should be aware that signs of bradycardia can periodically appear and disappear, therefore, they are not always detected on the ECG. The disease will be diagnosed if symptoms appear during the examination.

Another method for determining bradycardia is the Holter monitor. This is a lightweight portable device that allows you to track cardiac events throughout the day. It is convenient to always carry with you and monitor your heart rate. This is the most reliable way to diagnose incoming heart rhythm disturbances.

In addition, a laboratory study is carried out: a blood test (biochemical and general) and an analysis of thyroid hormones are prescribed.

A chest x-ray allows you to determine venous congestion in the lungs and the size of the shadow of the heart.

In addition, they use methods such as ECHO-KG (ultrasound of the heart), transesophageal examination, bicycle ergometry, coronary angiography, EFI (electrophysiological examination).

Features of bradycardia in children and what is its danger?

Everyone knows that the pulse reflects the frequency of oscillations of the heart muscle. A low pulse in a person can report the presence of various deviations and malfunctions in the heart. There are many factors that provoke this condition. These include meteorological dependence. The pulse may become weak due to taking medications that lower blood pressure.

Causes of bradycardia

The heart rate in people of different age categories is different, it ranges from 60 to 100 beats per minute. But it cannot be said that a one-time decrease to 50 beats per minute indicates pathology. There are many reasons why these values ​​may deviate from the norm. These include:

  • failures in the endocrine system;
  • arterial hypertension;
  • heart disease;
  • bad habits;
  • emotional stress;
  • heavy physical activity, including sports;
  • infectious diseases;
  • head trauma;
  • long-term use of medications;
  • hypothermia;
  • significant blood loss;
  • prolonged fasting.

The listed reasons affect changes in heart rate. Depending on the provoking factors, the following types of bradycardia can be distinguished:

With absolute bradycardia, a weak pulse does not affect the quality of life. A person does not experience any symptoms. Relative bradycardia manifests itself at the time of great physical exertion or develops against a background of serious diseases. Moderate bradycardia is most often diagnosed in children, while a low pulse is only shown at the time of sleep. The treatment is excellent depending on the type of bradycardia.

In cardiological practice, an asymptomatic course of bradycardia takes place. A weak pulse can be detected in an absolutely healthy person with normal pressure at the time of a planned medical examination. This is not a manifestation that threatens a person’s life, but such a pathology requires observation. With a weak pulse, the following often occurs:

  • dizziness;
  • fainting;
  • headache;
  • weakness;
  • neurological disorders.

Increasing manifestations can report irreversible changes in the work of the heart, a similar condition requires urgent treatment.

But often a low heart rate is not a concern for cardiologists at normal pressure. This often happens in athletes whose heart rate fluctuates within beats per minute, without unpleasant symptoms.

The average patients, whose pulse is less than 60 beats per minute, often turn to a cardiologist with complaints of weakness, shortness of breath, relaxation of brain activity. This condition requires study to determine the causes.

Of particular danger is a rare pulse, the frequency of which is less than 40 beats per minute. This can be critical, because the brain experiences oxygen starvation. This condition is accompanied by nausea and dizziness, in some cases, a sharp loss of consciousness.

The most dangerous is that the patient’s heart may stop, it becomes fatal in the absence of the necessary medical care. You should monitor your heart rate to prevent irreversible effects.

A rare pulse can be an individual feature of the body or a distinctive manifestation of heart disease. If your heart rate is less than 50 beats per minute, you should call the emergency team. A patient with loss of consciousness is hospitalized without fail. This condition is a threat to life.

It is dangerous to take drugs without a doctor’s prescription. In order to choose the necessary drug, it is necessary to undergo an examination, measure the pressure and frequency of oscillations of the heart muscle 2 times a day for a week. The following medications are prescribed:

The use of such drugs should occur under the supervision of a physician. In some cases, taking such medications can cause other pathological changes in the heart.

If the pulse is slightly reduced, at home you can slightly increase it, for this you need:

  • relax and rest;
  • drink a glass of green tea;
  • take a drug prescribed by your doctor.

It is also helpful to do light exercise. Some doctors believe that running at an easy pace helps to establish a heart rate. The patient is recommended a healthy lifestyle and a complete rejection of bad habits.


Treatment is directly related to the causes of the disease. Therefore, it is impossible to choose effective drugs on your own. A combination of drugs is selected by a cardiologist individually for each patient.

There are forms of bradycardia that do not require treatment, in which to normalize the pulse, it is only necessary to eliminate negative factors. If bradycardia is manifested due to medication, it is enough to change it to a drug that does not affect the heart rate.

A weak pulse is often not a danger to human life. But it is worth noting that a timely visit to a doctor is necessary. Do not self-medicate, it often aggravates the course of the disease and leads to irreversible consequences. Treatment of bradycardia with all kinds of herbs and infusions can begin only after consulting a cardiologist.


The main task of the heart is to contract with a certain frequency, transferring oxygen and nutrients to the organs with the flow of blood. Blood is an important transporter of vital elements from the heart muscle throughout the body.

The patient may not even suspect that he has such a disease as bradycardia. Symptoms may result in loss of consciousness of varying severity. Continued disregard for such manifestations can lead to serious complications and death.

Before a person loses consciousness, he may not experience any pronounced sensations and symptoms when compared, for example, with an attack of epilepsy. But the appearance of minor convulsions is not ruled out.

A patient with bradycardia before the approaching attack may turn red or, conversely, become very pale. Drops of sweat may come out. Such a condition is not always given a clear diagnosis, as the patient himself inattentively listens to his body and untimely seeks medical help.

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Causes of bradycardia

Is sport contraindicated?

When you go to medical forums, you constantly come across questions from worried parents about whether a combination is possible: bradycardia (as a manifestation of a somatic disorder in the child’s body) and sports (in any form).

The main thing is to correctly assess the general physiological state of a person, his abilities in terms of sports achievements and the adequacy of the load offered in various types of physical education. If the child has a pathology of the cardiovascular system, one does not need to expect record victories from him. Most likely, such a baby will achieve great results in science or creativity. But a complete exclusion of physical development in a child’s life cannot be allowed.

With congenital heart defects, regular long walks in the fresh air are necessary. It also does not hurt the gentle dousing, sunbathing. When doing gymnastics, a contraindication may be exercises with a turn of the body, in which the head end of the body is lower than the foot. And much more that you should definitely check with your doctor.

Physical exercises should be varied, contain a lot of positive emotions, elements of the game and much more. Water procedures, the pool will not only not worsen the condition of a person with bradycardia, but on the contrary will help his body better adapt to harmful environmental factors. A diagnosis of heart disease is not a sentence, and gymnastics and other sports will only give good results.

First of all, speaking about bradycardia in athletes, it should be mentioned that the pulse is less than 60, but not less than 40, may be a variant of the norm in a state of complete rest in a dream.

Bradycardia is a type of arrhythmia in which the heart contracts less than 50 times per minute.

Bradycardia in athletes, like in any other people, is not a disease, but only a manifestation of dysfunction of the cardiovascular system or, for example, endocrine diseases.

Often, trained people have physiological bradycardia, which is absolutely safe. The body, bearing heavy loads, seeks to compensate for their less costly activity at rest. It’s like a car engine – during the “rest” (idle), you should not just press the gas pedal, just as your heart should try not to “gain high speed” in idle mode.

Sport and bradycardia then become enemies when it turns out that the reason for the slowed heart rhythm is not physiological, but organic. That is, negative changes are present in the structure of the heart, endocrine organs or the central nervous system. Such bradycardia requires an accurate diagnosis of the causes of the appearance, as well as treatment. Naturally, this can only be entrusted to a cardiologist.

In any case, if you are involved in sports and you have bradycardia, it would be highly advisable to consult a SPORTS cardiologist. Since an ordinary doctor does not have enough experience and knowledge in sports cardiology.

Physical education (moderate and healthy physical activity) will undoubtedly not only bring health, but also are a prerequisite for a good state of the cardiovascular system. Sport, to some extent, will give an even more positive effect, but heavy loads, without which there will be no success in professional sports, leave their negative imprint on the health of the whole organism and the cardiovascular system in particular.

For a person with pathological bradycardia caused by heart disease, professional sports are life-threatening. However, regular healthy physical activity in the fresh air will definitely benefit.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.