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VERIFIED CONTENTAuthor: lek. Mariusz Basiura

Heart rate (pulse) is one of the basic, easily measurable vital signs. It provides a lot of important information about the state of the body, heart function and even well-being. High heart rate values ​​may suggest problems with the circulatory system, dehydration or, in some cases, be a symptom of shock and an immediate threat to life. So it's worth knowing how we define a pulse and what is the correct heart rate. What are the causes of slow and fast heart rate and what are the symptoms?

Heart rate (pulse, Latinpellere- hit, beat) - this term defines the rhythmic movement of vessels, consisting in stretching and contraction of their walls, due to the mechanical action of blood heart. Blood pulses in both arterial and venous vessels. However, pulsation in the veins is significantly weaker, which means that its measurement is less often used in diagnostics.

The arterial heart rate is the result of anterogradic (in the direction of blood flow) conduction of the heart in the form of a pulse along the vessel walls from the heart to the periphery. In the venous vessels, the venous pulse spreads anterogradically (in the opposite direction to the blood flow).

An example of the usefulness of measuring the venous pulse is recording the pulse in the jugular veins, which reflects changing pressures and blood flow in the right atrium of the heart.

How do we test the heart rate?

Pulse testing is a very simple test, it does not require additional devices, all you need is your hands and a watch. The evaluation of the pulse consists in examining the arteries located just below the surface of the skin, and most of all by palpation - that is, sensing the pulse waves with the fingertips and possible auscultation with the use of a stethoscope.

During palpation, the index and middle fingers are most often used. By pressing the palpable artery against the hard substrate (bone), you can catch successive blows of the blood wave stretching the walls of the vessels. The thumb should not be used for the test, because it is quite easy to confuse your own pulse coming from the thumb with the pulse of the artery you are examining!

Where do we measure the pulse?

In our body, we can distinguish several places where, due to anatomical conditions, arteries are quite easypalpable and often used for heart rate testing.

On the upper limb:

  • radial artery ( radialis artery ): located a few centimeters above the wrist, on the outside of the wrist
  • brachial artery ( artery brachialis ): palpable in the ulnar fossa, medially

On the lower limb:

  • superficial femoral artery ( arteria femoralis superficialis ): in the physical examination we look for it below the inguinal ligament, halfway between the anterior superior iliac spine and the pubic symphysis
  • popliteal artery ( poplitea artery ): examine it using both hands, the knee should be slightly bent, use the fingers of both hands to feel the artery in the popliteal fossa
  • dorsal artery of the foot ( arteria dorsalis pedis ): as the name suggests, it is located on the dorsal surface of the foot, lateral to the extensor tendon of the big toe
  • posterior tibial artery ( tibialis posterior artery ): palpable halfway between the posterior border of the medial ankle and the Achilles tendon

Other places include :

  • common carotid artery ( arteria carotis communis ) - on the neck available in the so-called carotid triangle, anteriorly from the anterior edge of the sternocleidomastoid muscle
  • axillary artery - ( arteria axillaris ) - at the top of the armpit;
  • superficial temporal artery ( arteria temporalis superficialis ) - is one of the terminal branches of the external carotid artery, as the name suggests it runs on the surface of the temporal bone

It is worth knowing that in life-threatening situations, it is the femoral and carotid arteries that are used as pulse search sites, because even at low values ​​of systolic arterial pressure (about 60-80 mmHg), the pulse on these arteries may be felt .

Types of heart rate, learning about heart rate

The we alth of information we get from heart rate analysis is best illustrated by the fact that a special branch of science has been distinguished, the so-called sphygmology, which examines the physiological meaning of heart rate for our body.

In Poland, the pioneer of heart rate science was the court physician of Zygmunt the Old and Zygmunt August, a Renaissance man and a world-famous physician - Józef Struś. Already in the 16th century, he published the work " Sphygmicae artis iam mille ducentos annos perditae et desideratae libri V ", in which he described different types of heartbeat, their diagnostic importance and the influence of various factors on heart rate.

When writing about the pulse, it is impossible not to mention the achievements of traditional Chinese medicine, in whichfor the analysis of the heart rate and its individual features, special diagnostic value is attached, and the number of diagnoses and conclusions based solely on heart rate examination goes beyond the scope of conventional medicine.

How to describe the heart rate, heart rate types, heart rate characteristics

Despite its simplicity in execution, the heart rate test provides a lot of information about the he alth of our body. When assessing the heart rate, we determine several of its features:

  • frequency (frequency)
  • regularity
  • filling
  • voltage
  • swiftness
  • height
  • symmetry

Frequency - the number of pulses of the pulse wave per minute. This value depends on many factors, both physiological and related to abnormalities in our body.

When palpating, it is quite common to count the number of beats in 15 seconds and then multiply the result by 4 to give it a pulse per minute. Taking into account the frequency, we can divide the rare heart rate ( pulsus rarus ) and the frequent heart rate ( pulsus frequens ).

These values ​​are closely related to the heart rate and the number of times the heart beats per minute. Therefore, when assessing the heart rate, always consider its correspondence with the heart rate. A situation where the heart rate value is lower than the heart rate is called heart rate deficit.

It may be caused by the most common rhythm disturbance in adults, atrial fibrillation.Correct heart rate- what is it?

Correct heart rate

Values ​​ Valid heart rateare age dependent.What is the correct heart rate ?

  • normal fetal pulse: 110-150 / min
  • correct heart rate in infants: 130 / min
  • correct heart rate in children: 100 / min
  • correct pulse in adolescents: 85 / min
  • correct adult pulse : 70 / min
  • correct heart rate in elderly people: 80 / min

Fast heart rate: causes, pathophysiology

The autonomic nervous system is responsible for the heart rate, and thus for the number of pulse beats perceptible in the vessels. It is divided into a parasympathetic part which slows down the heart rate and a sympathetic part which makes it faster. At rest, the parasympathetic system prevails, so during sleep our heart beats slower and the perceptible heart rate is less frequent. During exercise or during high emotional stress, the sympathetic system takes over, and we even "hear our heartbeat", the pulse is then fast.

Resting heart rate also depends on your level of fitness, and will be lower the better you areour body. The drop in the number of heart contractions, and therefore also in the heart rate, can be up to 15-20 beats per minute. This is called the phenomenon of resting bradycardia, which in athletes is most likely associated with the predominance of the parasympathetic system, although it is possible that other physiological processes are also responsible for it, not yet fully understood.

Heart rate is a parameter that is often used by athletes. An important element of training is determining the so-called maximum heart rate. There is a special formula thanks to which we are able to calculate the maximum heart rate, which should be reached during training, to reduce the intensity of exercise or to stop it, in order to protect the body against the harmful effects of murderous training. By assigning a maximum heart rate, you can also set a training target and see your progress in getting into shape.

The increased values ​​of the heart rate will also be responsible for all states causing an accelerated heartbeat, i.e. tachycardia (the number of heart contractions exceeds 100 / min). In addition to stress or physical exertioncorrect pulsedisturbs:

  • hyperthyroidism
  • fever as a defense reaction to inflammation in our body
  • dehydration
  • massive bleeding
  • anemia
  • heart disease, including heart rhythm problems
  • hypoglycemia
  • effects of certain substances that stimulate increased heart rate, such as caffeine, alcohol or drugs (cocaine, amphetamines)

Slow heart rate: causes

In addition to the training-related resting bradycardia mentioned above, the causes of slow heart rate include other causes of bradycardia (heart rate below 60 times per minute):

  • arrhythmia and conduction blocks
  • hypothyroidism
  • degenerative changes in the heart's stimulus-conducting system, i.e. a group of specialized cells responsible for causing heart contractions
  • severe hypothermia - body temperature below 28 degrees Celsius
  • overdosing on certain drugs, especially beta-blockers, glycosides
  • electrolyte disturbances, the most important of which is hyperkalemia - excessive blood potassium levels

Other features assessed during the heart rate test are:

Accuracy - we talk about regular (regular) heart rate when the intervals between the beats are the same and their strength is similar. Conditions associated with irregular heart rate include arrhythmias such as:

  • atrial fibrillation
  • tachycardia over andchamber
  • atrioventricular blocks

In medicine, the phenomenon of the so-called respiratory sinus arrhythmia. This is a physiological phenomenon in which the heart rate slows down during exhalation and accelerates during inhalation. The reason for this is the reduction in tonic activity of the vagus nerves during inhalation. Thus, the sympathetic nervous system, which speeds up the heartbeat, gains an advantage.

Filling - determines the measure of filling the artery with blood and results from the pulse amplitude, i.e. the difference between the systolic and diastolic pressure. Here we can distinguish, among others :

  • high heart rate (resulting from hypertension, fever or aortic valve insufficiency)
  • low heart rate (hypothyroidism, some medications) or threadlike heart rate ( pulsus filiformis )
  • threadlike heart rate can be a particularly disturbing sign of a life-threatening condition, e.g. caused by shock.
  • bizarre pulse (Latinpulsus paradoxus ) - contrary to the name, it is also a physiological phenomenon, and its essence is to lower systolic pressure during inhalation, which directly reduces the pulse filling and even its disappearance. However, if the decrease we observe is above 10 mmHg, we are dealing with a pathological phenomenon, and its possible causes may be, for example:
    • constrictive pericarditis
    • heart tamponade
    • aggravation of COPD
    • asthmatic state
    • massive pulmonary embolism
    • shock

Voltage - this is a feature of the pulse directly related to the amount of blood pressure. On its basis, we can distinguish the hard heart rate ( pulsus durus ) clearly marked; soft pulse ( pulsus mollis ), when the pulse wave is very weakly perceptible, or a double pulse, i.e. with two positive waves during a contraction.

Speed ​​- The speed of the heartbeat is really the speed at which a vessel fills with blood and collapses again within one heartbeat. The heart rate can be fast ( pulsus celer ) in aortic regurgitation or lazy ( pulsus tardus ) in aortic stenosis.

Symmetry - the last feature that should be checked when examining the heart rate is its symmetry on the limbs. It should be remembered because comparing the heart rate in symmetrical arteries to each other is a simple test, and allows to detect or conduct diagnostics towards diseases such as:

  • atherosclerosis of the lower limbs, leading over time to complete obstruction of the vessels and resulting in ischemialimbs
  • blockage of arteries, i.e. sudden closure of the vessel lumen by the embolic material
  • aortic dissecting aneurysm, which can be fatal if ruptured
  • less common Takayasu's disease or aortic stenosis, i.e. aortic coarctation

In the above article, I tried to describe, at least in part, what information our heart rate test provides us with. This amount is enormous and, taking into account the simplicity of the test, heart rate is definitely one of the basic parameters that we can use in the diagnosis of our malaise. We must also remember that when assessing it, the doctor takes into account the overall clinical picture.

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Category:

Cardiology