Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 35F, 145lbs, 511 dont smoke, drink rarely. Generally consider myself healthy, however mid last year I underwent double jaw surgery and have since not taken part in any form of exercise and feel very unfit, but I still eat a well balance diet for the most part!After surgery however I lost over 20lbs in around 2 months and then gained it all back in the following 4 I had a hard time psychologically during recovery for a plethora of varied reasons and also unexpectedly became a carer for a relative who developed dementia whilst I was still recovering, this took a toll on mental health and I fell into a bit of a depression, I was prescribed Sertraline 50mg in late September 2022 however my mental health has VASTLY improved, it is my physical health that is bothersome.I also have a history of IBS and GERD (diagnosed over 10 years ago so is my normal but has slowly gotten a little worse over time).I reached out with no urgency to doctors for a health check as my generally sense of physical health felt at an all time low. I wanted to reassess IBS and GERD with focus on regular urgent diarrhoea (occasionally up to 6x a day), and regular nausea. Additionally I find myself easily very short of breath, dizzy and nauseous, and ultimately I feel weak. The disconcerting feeling this brings means I avoid any physical activity (historically I have enjoyed being more active). I noted that my heart rate has been falling lower and lower in the last 8 months since surgery and I am not physically fit at the moment. I feel slow. Maybe I am just getting old I was given a battery of tests and most of my bloods are generally fine, I have some deficiencies eg. Folate (which I queried as I dont drink and enjoy my greens) but was advised that some people are built different and need more vits or nutrients than others and I just need to take supplements  I assume this may cause some of my symptoms such as diarrhoea?I also had a 24hr Holter monitor and results came through yesterday. I havent seen them but doc noted 357 counts of bradycardia with lows of 37bpm. Coupled with my nausea and dizziness, I have an urgent referral to cardiology (although that still means in 3 months).However when I read up on Bradycardia, it doesnt seem to be a concerning issue? I dont have the full results but is it only the coupling of my nausea etc that makes it more concerning. Unsure if relevant, but despite low heart rate I often have slightly high blood pressure.Tldr: is bradycardia with nausea and dizziness worthy of urgent cardiology referral? Can heart issues cause additional symptoms such as regular diarrhoea?Also not sure if relevant, but I had a persistent rash and redness and deep itch in left breast for last 2 months, ultrasound shows I have lots of benign cysts and a fibroadenoma, they (radiologist and consultant) seemed unconcerned but did biopsy due to my age and I will get results soon, the lack of concern from consultant means I have little concern also (my mother has fibroadenomas that have never caused any issues), but thought I would add everything that ails me! Ha! In case there is some magical connection to it all.Thanks!. ### Response: What is your normal heart rate? Was it sinus bradycardia? How long were these episodes in duration?. Also would be helpful to know any medications other than the SSRI and whether you have sleep apnea, have had Lyme or chagas disease or are hypothyroid.To he honest I would also be surprised if it is sinus bradycardia that it is causing your symptoms rather than vice versa. Nausea and bowel movements are an excellent way to temporarily lower your heart rate. Most often it is just a normal variant, and if it is sinus bradycardia almost never requires a pacemaker. Wouldnt get too overwrought.The downside is i there is no magical connection here to any issue other than maybe being a symptom of nausea, which isnt that magical..