76 Year Old Man, High Blood Pressure, Resting Pulse Of 36

[hc4361]

He has COPD but has become increasingly breathless over the past few weeks relying more on his inhalers and moving much less.
A routine checkup found that he has a resting pulse of 36 and an ECG was carried out on the spot. The results were 'worse' than the previous two. The low pulse is a new development.
He is now booked in for an echo-cardiogram this coming Friday but we are all a bit in the dark as to what this low pulse rate means and more importantly what he should or should not be doing.

He also has essential thrombocythemia for which he takes the appropriate drugs - it is well controlled and closely monitored. He is also losing weight. His full range of blood tests came back normal.

The questions are:
Should we be worried?
What does the low pulse mean?
Is it safe for him to be active if he wants to, in particular have sex with his wife?
What could be the cause?

Many thanks for all your advice

[Sqad]

Should we be worried?......Yes.
The slow pulse rat is almost certainly due to what is known as bundle branch block and is indicative of coronary Artery Disease ( Ischaemic heart disease).
There could be many causes for this situation, but the commonest cause by far is what i have described....coronary artery disease.

If my prognostications are correct, he will require the insertion of a
Pacemaker.

[hc4361]

Thanks for that, Sqad. What can he do in the mean time? Should he still be having sex, driving, anything?

[Sqad]

With that pulse rate and his COPD he shouldn't have the energy to do all those things.
Yes, he can drive and do anything else that he feels up to doing.

[hc4361]

Thanks again, much appreciated

[hc4361]

Sqad, he has had the echocardiogram and his pulse is not below 40. I don't properly understand it but the second pulse comes very quickly after the first and is too 'faint' to be picked up by the blood pressure monitors the GP used. His heart beat is in the 70s range.

There is a 'long' gap between the second and third beat which means there is more time for the blood to build up in the chamber giving the illusion of high blood pressure.

His results have to be examined by the cardiologist but it seems there is nothing to worry about, or nothing to worry about with urgency.

Thanks again for your advice. I will let you know of any further developments and would appreciate your view on this update

[Peter Pedant]

// What can he do in the mean time? Should he still be having sex, //

er more sex I would have thought....

anyway I think the fella is being well treated and the requisite treatment is being carried out