Low heart rate: how much to worry and what to do?

• I went to see the doctor this morning about some stomach pain I thought might be an ulcer. When the nurse checked my heart rate, it was 48 bpm. Neither the nurse nor my doctor (who knows my med history) said anything about this. I wasn't concerned until I googled it when I got home, and now I'm having a lot of anxiety about it. Called my doctor and he said that a one time reading of 48 with no other symptoms is not troubling. Nurse said I should check my pulse tomorrow and if it's still in the 40s, call them. How much should I be freaking out right now? I have a lot of anxiety issues and am prone to cyberchondria, and the Google tells me that my heart rate is abnormally low and I'm kind of freaking out. Google tells me normal is 60-100, below 50 can be Not Good. I am a 27 year old male, 6'1", ~175 pounds. I eat a very healthy diet, practice relatively rigorous yoga 4-6 times per week along with some meditation, but I do not consider myself an 'athlete' by any means. I used to be a pretty heavy drinker and occasional smoker, but I quit all of that and now I drink very rarely. No coffee because of my anxiety, though I drink green tea some mornings. Last month I had complete metabolic profile done, complete physical, and everything checked out fine. I have always had low blood pressure. I don't really track my heart rate in any consistent way, so I don't have a lot of comparative data. I've been taking Klonopin for a little bit to get through an extremely anxious time - no more than .5mg 2x a day (1 mg total). I had not taken my klonopin this morning before my pulse was checked, but I did take it last night. I also recently started Lexapro at 10mg a day, with the goal of quitting the klonopin and treating my anxiety with an SSRI. I was also on 12 hour fast because of a blood test I needed to have done. I don't know how much of a difference any of this makes. No other symptoms, other than feeling perhaps a little more tired and run-down than usual, which I've attributed to the fact that I moved last week, it's the end of a really anxious couple of months (work stuff), my adrenaline has been going crazy, and I'm just crashing a little. The klonopin also makes me sleepy. A month ago when I went in for my annual physical, my heart rate was 68. I'm concerned about the drop. Doc says not to worry, but, you know, I have anxiety problems. I just checked my pulse rate and it's at about 52, which is still pretty low. How worrisome is a heart rate of 48? What does it mean if I still have that heart rate tomorrow? Is it really okay to wait until tomorrow and see if it's still low (i.e. should I trust my doctor, or does this seem a more emergency type situation)?

• Answer:

  IANYD. But yes, it is really OK to wait until tomorrow. If you need reassurance, you know you can check your heart rate anytime you want with just your fingers, right? Just the act of getting anxious about it will probably get you up plenty higher than 48. Remember that reading was just a moment in time, people can have readings above or below the normal range transiently and it doesn't mean their heart rate is always low or high.