A nurse is evaluating four patients in the emergency department. For which patient is a heart rate of less than 60 beats per minute most likely a benign physiological finding requiring no immediate intervention?
A 75-year-old patient with a heart rate of 52 bpm who reports episodes of dizziness and syncope.
A 58-year-old patient with a heart rate of 50 bpm and a new third-degree AV block on the EKG.
A 22-year-old marathon runner who is asymptomatic with a heart rate of 48 bpm.
A 45-year-old patient with a heart rate of 54 bpm who was recently prescribed a beta-blocker.
While a heart rate below 60 bpm defines bradycardia, its clinical significance depends on the context. In a well-conditioned athlete, a low resting heart rate (athlete's heart) is a normal physiologic adaptation due to increased vagal tone and cardiac efficiency. This finding is typically asymptomatic and benign. In contrast, bradycardia associated with symptoms like dizziness or syncope, the initiation of rate-slowing medications like beta-blockers, or high-degree AV blocks on an EKG are all potentially pathologic findings that require further evaluation and possible intervention.
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Cardiovascular Emergencies
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