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The Role of Vital Signs in the Diagnosis of Bradycardia
A heart rate of 38 and an otherwise relatively healthy person would be generally not associated with symptoms. A depressed level of consciousness out of keeping with what you might expect from somebody with bradycardia would make me suspect that there's something else going on. The exam is going to be really important here. So, you know, are they pale? Are their extremities very cool? Are they having poor urine? You need to dig a little bit more to identify Overt bradycardic shock.