Sinus Bradycardia

[Ian J]

Just had my Army flight physical and the EKG revealed I had Sinus Bradycardia. This wasn't a surprise... the EKG says that every year. I know what sinus bradycardia is, and what the doc tells me is not to worry, it is normal in well-conditioned athletes. I got to thinking, what is the definition of a well-conditioned athlete? I stay in shape, sure, but when I think "well conditioned athlete" I think Olympic-level, which I am not. Just want to make sure I wasn't getting the blow-off from the doc and wanted to know if I should worry about heart disease? If it helps, my resting pulse was 48 and my BP was 103 over 50 something. Thanks!

[My Flight Surgeon]

If you are exercising to the point where your pulse rate is less than 60 per minute (the definition of bradycardia) you are a well conditioned person. This is especially true if you are not symptomatic with feeling weak when exercising.

Keep it up.

[Ian J]

Okay... thanks! Nope, don't feel weak when exercising... so, no heart attacks for me then, right?

[My Flight Surgeon]

"Heart attacks" (mycardial infarction or death of heart muscle) really don't have much to do with fitness and braycardia other than allowing you more cardiac reserve to survive. They are more related to high blood pressure, cholesterol, family history (ahh, your genes), smoking, and diabetes. That is why it is important to know what your lipid (cholesterol, the good, the bad and the total) levels are, whether or not you are a diabetic, your family history and your blood pressure. Smoking cessation is extremely important here also.

In my practice, I ask all patients (and I only take care of pilots) if they know their cholesterol. If they have not had one checked in 5 years, I recommend getting one. If the Total cholesterol is above 200, or the HDL cholesterol is less than 40, or the LDL cholesterol above 100, I recommend treatment with a statin (Lipitor, Zocor, Lescol, Mevacor, Pravachol, Crestor, Vytorin) to change these numbers. There have been good studies to demonstrate that if there is a cholesterol plaque (buildup) in the arteries, it can be disolved with these drugs. Once the plaques have been around for many years, calcium gets deposited in the plaque and the plaque can no longer be disolved. Diet works so-so and is not too effective in lowering cholesterol.

One more word about the cholesterol numbers, the laboratories will show that an LDL of 139 is normal but the National Institutes of Health say optimal levels are below 100.

[ETAV8R]

Are these meds ok per FAA?
Do we need to report taking them? I had better get my cholesterol checked.

[My Flight Surgeon]

Yes, you need to report ALL medications on the medical. All of these medications for cholesterol are OK. The FAA would rather have you healthy than to fly around an increased risk because you have an elevated cholesterol level.

[Ian J]

Originally Posted by My Flight Surgeon

"Heart attacks" (mycardial infarction or death of heart muscle) really don't have much to do with fitness and braycardia other than allowing you more cardiac reserve to survive. They are more related to high blood pressure, cholesterol, family history (ahh, your genes), smoking, and diabetes. That is why it is important to know what your lipid (cholesterol, the good, the bad and the total) levels are, whether or not you are a diabetic, your family history and your blood pressure. Smoking cessation is extremely important here also.

In my practice, I ask all patients (and I only take care of pilots) if they know their cholesterol. If they have not had one checked in 5 years, I recommend getting one. If the Total cholesterol is above 200, or the HDL cholesterol is less than 40, or the LDL cholesterol above 100, I recommend treatment with a statin (Lipitor, Zocor, Lescol, Mevacor, Pravachol, Crestor, Vytorin) to change these numbers. There have been good studies to demonstrate that if there is a cholesterol plaque (buildup) in the arteries, it can be disolved with these drugs. Once the plaques have been around for many years, calcium gets deposited in the plaque and the plaque can no longer be disolved. Diet works so-so and is not too effective in lowering cholesterol.

One more word about the cholesterol numbers, the laboratories will show that an LDL of 139 is normal but the National Institutes of Health say optimal levels are below 100.

Thanks for the info Doc. Part of the flight physical is cholesterol, but I haven't go the lab results back yet. I'll check on it when I do and follow your advice. Thanks again!