Varies. They will do an ekg to look for electrical "block" (delayed conduction). He/she'll look at any medicines you may be taking. The doc may want to record your heart rhythm for 24 hours to see how slow you go during sleep. Sometimes treadmill exercise can be a helpful test. There are other, more sophisticated testing that is sometimes necessary.
Yes maybe. If you get dizzy/lightheaded, feel like you could pass out, you should. Are you on any medications that can slow the heart down. Your heart rate should be above 50 bpm. If not, you may have several different causes, sinsus brady, av block, type 1 or type 2 heart block maybe even type 3 heart block but I doubt this one at your age. Have you doc check med cause first. May need holter and ekg.
Bradycardia. A doctor's exam can tell you lots of things about your slow heart rate. People can have heart rate normally if they do regular exercises, if they are on certain medications that can cause slow heart rate. Also if they have sinus node dysfunction, as well as if they have complete heart block. Most importantly if they have vagus stimulation for any reason.
A few things... An experienced doctor can narrow down the diagnoses depending on how slow, regular, or irregular your heart rate is. Also, your medical history, medications, etc. Can lead to some conclusions. However, the best next test is an ekg to really examine the heart rhythm.
Symptoms. If you feel fine, you can wait forever. The primary indication for a pacemaker is symptoms. Important symptoms include passing out or nearly passing out. Dizziness and fatigue may be due to something else but slow heart rate should be considered carefully. People usually feel fine with heart rates of >50. Persistent heart <50 while awake should be evaluated. <40 needs a checkup now.
All cardiac exams are normal. PVCs occurring all day, slow heart rate, headache & blurred vision. All labs normal except low iron & glucose.?
Anxiety related. If your cardiac work up is normal, the extra PVC, s you seem to be having may be due to some genetic predisposition. Unless you are having symptoms due to frequently occurring PVC's, I would focus on any anxiety issues or emotional stress that may be exacerbating the problem. Relaxation Exercises would be a good idea. Feel better.