The description of the pulse is normal. Pulse of weak or strong filling. Pulse measurement technique

Pulse is the vibrations of the walls of blood vessels caused by rhythmic successive contractions and relaxations of the heart. In medicine, its arterial, venous and capillary varieties are distinguished. A complete characteristic of the pulse allows you to get a detailed picture of the state of the vessels and the features of hemodynamics (blood flow). The indicators of the carotid and radial arteries are of the greatest practical importance. Measuring the parameters of their work allows diagnosing cardiovascular diseases in time.

Six basic characteristics of the pulse

Rhythm

Rhythm - the alternation of cardiac vibrations at regular intervals. Most often, a violation of the cycle can be caused by extrasystole(the appearance of foci that produce additional signals of contraction) or heart blockade (i.e., a violation of the conduction of nerve impulses).

Frequency

Heart rate (HR) is the number of heartbeats per minute. There are two types of deviations:

bradycardia (up to 50 beats / min) - slowing down of the heart;
tachycardia (from 90 beats / min) - an increase in the number of pulse waves.

It is calculated using a tonometer or by palpation for 1 minute. The rate of heart rate depends on age:

newborns - 130-140 beats per minute;
children under 1 year old - 120–130 beats;
from 1 to 2 years - 90-100 beats;
from 3 to 7 years - 85–95 beats;
from 8 to 14 years old - 70–80 beats;
adults from 20 to 30 years old - 60–80 beats;
from 40 to 50 years old - 75–85 beats;
from 50 years old - 85–95 beats.

Value

The magnitude of the pulse shock depends on the voltage and filling. These parameters are determined by fluctuations in the degree of the walls of the arteries between systole, diastole and the elasticity of the vessels. There are the following deviations:

A large pulse (i.e., when more blood begins to be pumped through the arteries with an increased tone of the blood tract) is observed with pathologies of the aortic valve, hyperfunction of the thyroid gland.
Small. It can be caused by narrowing of the aorta, cardiac tachycardia and increased vascular elasticity.
Filiform. (i.e. when the beats are practically not felt). Associated with shock states or significant blood loss.
Intermittent. Occurs when alternating oscillations of small and large waves. Usually its occurrence is caused by severe damage to the myocardium.

Voltage

It is determined by the force that must be applied in order to completely stop the flow of blood through the artery. It depends on the level of systolic pressure. There are the following types of deviations:

tense or hard pulse - with high pressure in the vessel;
mild - observed if the artery can be blocked without much effort.

Filling

It depends on the amount of blood ejected into the arteries. The degree of fluctuation of the walls of blood vessels depends on this. If this parameter is normal, then the pulse is considered full.

An empty pulse indicates that the ventricles are not ejecting enough fluid into the arteries.

The form

It is determined from the speed of change in the level of pressure between contraction and relaxation of the heart. There are several types of deviations from the norm:

A fast pulse occurs when a lot of blood flows from the ventricles with high elasticity of the vessels. This causes a sharp drop in pressure during diastole. It is a sign of aortic valve insufficiency, less often - thyrotoxicosis.
Slow. Characterized by low pressure drops. It is a sign of narrowing of the aortic wall or mitral valve insufficiency.
Announcer. It is observed if an additional wave passes through the vessels in addition to the main one. Its cause is a deterioration in the tone of peripheral vessels during normal myocardial function.

One of the properties of the pulse is its filling. Basically, it depends on the volume of blood that is ejected from the heart into the aorta and enters the arteries during each heartbeat.

The arterial walls are elastic, therefore, when a pulse wave passes, the vessels are somewhat stretched under the influence of blood pressure. The feeling of changing pressure in the vessel when probing the pulse, for example, on the radial artery, characterizes its filling.

The pulse, depending on the height of the filling wave, can be divided into 4 groups:

Moderate pulse;
Full pulse;
Empty pulse;
Thready pulse.

Factors that determine the filling of the pulse

This property of the pulse wave is determined by two factors:

stroke volume;
volume of circulating blood.

Stroke volume is the amount of blood ejected from the left ventricle of the heart during its contraction (systole). Normally, it is 40 - 70 ml. With a significant increase in heart rate, the diastole period is shortened, during which the left ventricle is filled with blood from the left atrium, so its quantity, and, consequently, the stroke volume, decreases with severe tachycardia.

The volume of circulating blood is the amount of blood pumped by the heart through the bloodstream. Normally, it is 4.7 - 5 liters per minute. This value may decrease with fluid retention in the extravascular space, for example, caused by edema. Also, the volume of circulating blood decreases with dehydration caused by external causes (lack of fluid received) or with an increase in urine volume, for example, in diabetes and diabetes insipidus.

The volume of circulating blood increases:

with an increase in the energy needs of the body (physical activity);
with an increase in plasma volume (intravenous infusion of large volumes of solutions);
with an increase in the number of red blood cells (erythremia and erythrocytosis).

All these states are reflected in the filling of the pulse.

This is a subjective value. You can learn to determine the filling with regular palpation of the pulse in people with various diseases. Medical students are taught this in practical classes.

An ordinary person can determine the filling by comparing the sensations of probing the artery in different conditions - during exercise, lying down, during an increase in body temperature, and so on.

To determine the filling of the pulse, you must:

put the index and middle fingers of the hand on the border between the lower third of the forearm and the wrist;
feel the pulsation of the radial artery;
pinch the artery with a finger located closer to the elbow until the pulsation stops, which is determined with the help of a second finger located lower along the artery;
gradually raise the finger that has pinched the vessel until the pulsation is fully restored.

The resulting sensation of blood pressure will characterize the filling. Abnormalities are called full (pulsus plenus) and empty (pulsus vacuus) pulse. The full pulse is determined even without pressing on the wall of the artery; it is very difficult to find an empty one.

Causes of increased filling of the pulse

A full pulse is observed with an increase in the stroke volume of the heart and / or with an increase in the volume of circulating blood.

In a healthy person, it can be recorded during physical activity. The higher the fitness, the more efficiently the heart contracts. This determines the limit to which an increase in heart rate is accompanied by an increase in stroke volume. For example, with a pulse equal to 150 per minute, its filling will be different for an athlete and an untrained elderly person.

Also, a well-filled pulse is characteristic of physiological erythrocytosis, that is, an increase in the number of red blood cells in the blood. This is mainly characteristic of the inhabitants of the mountainous area.

Pathological conditions and diseases accompanied by a pulse of increased filling:

arterial hypertension, especially in the early stages of development;
hyperthyroidism, that is, excessive hormonal activity of the thyroid gland;
a significant volume of intravenous infusions, exceeding the needs of the body;
respiratory failure in lung diseases;
chronic poisoning with copper, phosphorus, manganese, cobalt;
erythremia is a tumor of the bone marrow, accompanied by the production of an excess of red blood cells in it.

Causes of weak filling of the pulse

A pulse of weak filling is recorded in diseases accompanied by a decrease in the stroke output of the heart or a decrease in the volume of circulating blood. Possible reasons:

acute heart failure in myocardial infarction complicated by hypertensive crisis;
paroxysmal tachycardia - supraventricular and ventricular;
tachysystolic form of atrial fibrillation, or atrial fibrillation;
ventricular fibrillation and flutter - life-threatening arrhythmia;
chronic heart failure III - IV functional class, accompanied by a deterioration in systolic function of the myocardium, that is, a decrease in its contractility;
dehydration caused by intense sweating and insufficient water intake into the body (work at high ambient temperature);
acute vascular insufficiency that occurs with any type of shock - anaphylactic (allergic nature), hemorrhagic (with rapid blood loss), traumatic, pain, etc .;
arterial hypotension - a decrease in blood pressure in hypothyroidism, adrenal insufficiency;
anemia resulting from acute blood loss after trauma, surgery, bleeding;
diabetes insipidus, in which up to 10-12 liters of fluid per day are lost in the urine;
decompensation of diabetes mellitus, accompanied by a significant amount of urine;
severe renal failure;
significant burns;
diseases accompanied by repeated vomiting and / or prolonged intense diarrhea, for example, cholera and other intestinal infections.

A weak, thready, or empty pulse is of greater clinical significance, since it is caused by a significant violation of myocardial contractility or severe disturbances in the vascular bed. Such conditions are accompanied by oxygen starvation of the brain, kidneys, heart and require emergency medical care.

The human body is a complex system, where each organ, tissue and bone has its own role. It resembles a watch mechanism: all parts are connected to each other and do not stop their work even for a second.

Of course, such a complex system needs its own signals that would tell a person about his state of health.

shrinking the heart pushes blood through the arteries, which then fills each vessel and vein, thereby ensuring the correct functioning of the organs.

The largest artery in the human body is the aorta. Blood rushes into her with such force that "shock wave" passes through all bloodstreams. You can feel it if you clamp the wall of the artery in the right place. It is this powerful push that is commonly called the pulse.

It must be said that many factors influence the indicator. When you worry, you feel your heart pounding in your chest, and your pulse speeds up. Whereas, if you are too cold, then all processes in the body begin to slow down.

In addition to anxiety, a stimulating fact is also physical activity, strong emotions, drugs and much more.

Measurements must be taken by all teenagers who are engaged in sports sections..

At this age, the body undergoes the most significant changes, so a too high indicator may be the first news that this sport is not suitable for a person.

Such an examination is a daily duty and for professional athletes. However, in their case, this is due to the selection of a training program, it is its effectiveness, as well as whether it suits the athlete or not, will show the pulse.

If you regularly visit the gym, then you probably know that many programs, whether it's training for gaining muscle mass, losing weight or a simple warm-up, are designed for a certain range of a person's heartbeat. Measurements in this case will tell you whether you are conscientiously performing the program or not trying hard enough.

Checking this indicator daily should become a habit not only for the elderly, but also for those who have serious heart problems.

In addition, such measurements are carried out by emergency doctors with a heart attack, fainting, as well as severe bleeding. However, the pulse will tell about health problems long before the inevitable happens. You just need to be able to understand what your body is telling you.

Step-by-step measurement algorithm: how to count heart beats

The easiest way - pinch an artery with two fingers in the place where the pulse is determined in a person. This can be done near the wrist, on the temples, or on the inside of the foot.

If you are taking measurements in a small child, it is better to do it at the temples. For an independent procedure, the radial artery, located next to the hand, is best suited.

Gently press on the artery with two fingers, but keep in mind that the pressure should be minimal.
Count the jolts you will feel for 60 seconds.
The resulting figure will be your indicator.

In addition to the method already described, research can be carried out using a special device. Outwardly, it resembles a small counter and a cuff, which is tightly fixed near the wrist. The device will count the pulse for 1 minute. This method is more accurate than palpation.

Norm by age in men, women, adolescents and toddlers

I must say that in children the figure is much higher than in adults, especially for newborns. What is the normal pulse rate for a newborn baby?

Many mothers are frightened if their young children have a measurement above 100, but this is normal. Ideally, the pulse of the newborn should be 140 beats per minute, but other indicators in this range are possible. The main thing is that the figure should not be less than 110 strokes and more than 170.

From the first month of life to a year the indicator usually changes slightly. The norm is data from 102 to 162 beats per minute, and best of all, if it is 132.

From 1 year to 6 years the baby is actively growing and developing, and his physical activity goes off scale, so a normal pulse in a healthy child should be in the range from 90 to 150.

Ages 6 to 12 When a child begins to study at school, the decrease in physical activity also affects the state of the body. The norm is an indicator from 75 to 115.

In adolescence (12-15 years old) the pulse slows down significantly, and therefore should be in the range from 55 to 95.

The average heart rate of a healthy adult ( from 15 years old to 50 years old) is 70 beats per minute, but 60-80 beats are also normal.

At 50-60 years old rises again, so daily measurements are necessary. Normally, the pulse rate in the elderly varies from 74 to 79 beats per minute - this is considered normal, although more than other values.

Of course, a person is not always at rest, and therefore the pulse can often be higher or lower than normal.

Rapid heart rate is normal during exercise. In addition, the pulse accelerates if you are worried or experiencing any strong emotions. It is about this state that they say: "the heart jumps out of the chest."

Slowdown is usually observed if you find yourself in a hot tropical climate. Rest in the countries of Southeast Asia is contraindicated for people with problems of the cardiovascular system, since the climate there implies not only heat, but also high humidity. An unprepared body is prone to overheating, which adversely affects the condition of the heart.

If you do not have diseases of the cardiovascular system, then a slight decrease in the indicator is normal., however, "cores" should carefully monitor their health while in a hot country.

Learn more about what is the normal pulse rate for a healthy adult (both men and women), how many heart beats per minute should be in a calm state, and in what cases it is worth worrying about a deviation from the normal heart rate:

Causes of increased heart rate

A rapid heartbeat (tachycardia), which is the cause of an accelerated pulse, may be the first bell of such serious problems as:

Infection. In this state, there is also a slight increase in temperature.
Wrong work of the heart. Any damage to the heart muscle and insufficient blood circulation also lead to an increase in the rate.
Bleeding, fainting and any other shock conditions. Such a collapse causes a decrease in pressure and leads to an immediate, acute reaction of the whole organism.
Abuse of caffeine and alcohol. A lot has already been said about the dangers of both substances for the heart. Any excesses in the use of alcohol and caffeine immediately affect the work of the heart and pulse.

If there is such a problem, try to calm down first. Lie on your back and eliminate all irritants, be it bright lights or noise. Breathe deeply. This may be difficult at first, but after a few such breaths, the heartbeat will begin to slow down.

If you do not have the opportunity to lie down, then it will be enough rinse your face with cold water several times. This will trigger the "dive reflex" and slowing down will naturally occur.

However, after such a situation, it is imperative to consult a doctor, as this can be a symptom of serious illness.

To learn more about how you can calm your heartbeat, see this video:

Why it slows down and what to do about it

A pulse is considered rare if it beats less than 60 times per minute. This state is called " ", and it can be a concomitant factor in the following diseases:

Thyroid diseases;
Cerebral edema, the presence of a tumor, cerebral hemorrhage, meningitis;
Poisoning with drugs or chemicals;
Taking beta blockers;
Infectious diseases.

However, in addition to such serious problems, a slow pulse is possible due to prolonged exposure to cold or low blood pressure.

In this case, small physical activity will help to return to normal, for example, walk outdoors for 20 minutes, swim, run.

You can resort to caffeinated substances, however, if you have heart disease, then you should not abuse this method. Taking a hot bath will help increase your heart rate.

What examinations can the doctor prescribe

With tachycardia and bradycardia, doctors prescribe the following examinations and tests:

Ultrasound of the heart. Most often prescribed to people with chronic or hereditary diseases, whether it be hypertension, coronary disease, and heart disease. It is necessary to analyze the state of the organ itself and its valves.
. Thanks to the measurement of electrical pulses, the doctor has a complete picture of the frequency and rhythm of contraction of the organ, the work of the ventricles of the heart, as well as the slightest manifestations of serious diseases.
. Shows the number of blood cells, and in case of their deficiency, is the basis for additional examinations for the presence of diseases such as leukemia or anemia (anemia).
Blood test for thyroid hormones and urine test are mandatory with an accelerated pulse, since problems in the endocrine system are often the cause.

Of course, not always the acceleration or deceleration of the human pulse from the norm is a signal of a serious illness. If you had such a problem once, then most likely the reason lies in your mental or physical state at the moment.

However, if the indicator is far from normal and is accompanied by nausea and dizziness, then after taking the necessary measures to normalize it, you should consult a doctor. Perhaps there will be no cause for concern, but it is better to engage in prevention than the treatment of advanced diseases.

The features of diagnosing people with heart rate disorders are described in this video:

The normal pulse is characterized

satisfactory filling. With a large cardiac output, a large filling or full pulse (pulsus plenus) is observed, for example, with aortic valve insufficiency. A small filling pulse, called weak or empty (pulsus inanis, vacuus), is due to low cardiac output, indicating significant myocardial damage. A barely palpable pulse is called threadlike (pulsus filiformis) and is often observed in acute vascular insufficiency (fainting, collapse, shock).

With atrial fibrillation, which is characterized by the absence of atrial systole and various diastolic filling of randomly contracting ventricles, the pulse waves following each other are not the same in filling. The weakest do not reach the radial artery, as a result of which the pulse rate is less than the heart rate. This difference is called pulse deficit. (pulsus deficiens).

The voltage of the pulse is determined by the level of arterial pressure and is characterized by the force necessary to clamp the artery. To do this, with a finger located proximally, the artery is completely clamped. The cessation of pulsation is determined by the middle finger. In healthy people, the pulse is not tense. With low blood pressure, the pulse may be soft (pulsus mollis), with high - hard (pulsus durus).

The state of the vascular wall outside the pulse wave is determined by clamping the radial artery with the ring and index fingers until the pulsation stops. Palpate the artery with the middle finger. In healthy individuals, it is not felt outside the pulse wave, and in atherosclerosis, due to the compaction of the arterial wall, it is determined in the form of a dense cord.

In some diseases, additional characteristics of the pulse are also described - the size and shape, which are derived from its filling and tension. The pulse of increased filling and tense is called large (pulsus magnus), weak filling and soft - small (pulsus parvus). Fast and high (pulsus celer et altus) is a pulse with a sharp rise and a quick spa-

the house of a pulse wave, greater than normal amplitude. It is observed with aortic valve insufficiency, hyperthyroidism. A pulse with a slow rise and fall of the pulse wave is called slow (pulsus tardus) and is observed with stenosis of the aortic mouth.

In some cases, pathological changes in the pulse are determined on the carotid, temporal, femoral, popliteal and other arteries. For example, with atherosclerosis of the vessels of the lower extremities, a decrease in the amplitude of oscillations of the arteries or the absence of their pulsation is often observed, especially often on the arteries of the rear of the feet.

Palpation of the region of the heart. When feeling the region of the heart, the apical and cardiac impulses, retrosternal and epigastric pulsations are determined.

The apex beat is palpated in approximately 50% of healthy individuals. To determine its approximate position, the palm of the right hand with the thumb abducted is placed horizontally under the left nipple. Then, with the 2nd and 3rd fingers, the localization, area, strength and height of the push are specified.

Normally, in the standing position, the apex beat is located in the 5th intercostal space 1-1.5 cm medially from the midclavicular line. In the position on the left side, the apex beat shifts to the left, and on the right side - to the right. The position of the apex beat depends on changes in the heart itself or its surrounding organs. The displacement of the apex beat outwards is observed with the expansion of the left ventricle (myocardial damage, heart defects). An increase in pressure in the pleural cavity (effusion, hydrothorax) leads to a shift of the heart and apex beat to the healthy side, and pleuropericardial adhesions shift them to the diseased side.

The area of the apex beat is normally no more than 2 sq. cm. It becomes diffuse with dilatation of the left ventricle. The apex beat is not determined if it falls on the rib, as well as with emphysema and exudative left-sided pleurisy.

The height (amplitude) of the apex beat is determined by the range of oscillations of the chest wall in the area of the beat. It is proportional to the amount of cardiac output.

The strength of the apex beat is determined by the pressure it exerts on the palpable fingers. With hypertrophy of the left ventricle, a strong (resistant) apex beat is determined.

The cardiac impulse is palpated near the sternum, in the 3-4 intercostal spaces on the left. Its appearance is associated with hypertrophy of the right ventricle.

There is no retrosternal pulsation in healthy individuals. It is determined by palpation in the jugular fossa with an enlarged or elongated aorta, insufficiency of the aortic semilunar valve.

Epigastric (epigastric) pulsation may depend on right ventricular hypertrophy, fluctuations in the wall of the abdominal aorta, and pulsation of the liver. With hypertrophy of the right ventricle, it is localized under the xiphoid process and becomes more distinct with a deep breath. With an aneurysm of the abdominal aorta, it is detected somewhat lower and directed from back to front. The pulsation of the abdominal aorta can also be determined in healthy people with a thin abdominal wall. The pulsation of the liver, felt in the epigastrium, is transferable and true. The transmission is due to contractions of the hypertrophied right ventricle. True liver pulsation is observed in patients with tricuspid valve insufficiency, when there is a reverse flow of blood from the right atrium into the inferior vena cava and liver veins (positive venous pulse). Each contraction of the heart causes it to swell.

P e r k u s s and i. Percussion of the heart is performed to determine the size, position, configuration of the heart and vascular bundle. The right border of the heart, determined by percussion, is formed by the right ventricle, the upper one by the left atrial appendage and the cone of the pulmonary artery, and the left one by the left ventricle. The right contour of the heart in the X-ray image is formed by the right atrium, which is located deeper and lateral to the right ventricle and therefore is not determined by percussion.

Most of the heart is covered from the sides by the lungs, and only a small area in the center is directly adjacent to the chest wall. As an airless organ, the part of the heart that is not covered by the lungs gives a dull percussion sound and forms a zone of absolute dullness of the heart. Relative cardiac dullness corresponds to the true size of the heart and is its projection onto the anterior chest wall. In this zone, a dull sound is determined.

Percussion can be performed in the horizontal and vertical position of the patient. First, the right border of relative cardiac dullness is determined. Since the position of the borders of cardiac dullness is affected by the height of the diaphragm, it is first necessary to find the upper limit of hepatic dullness. The finger-plessimeter is placed horizontally and percussion is carried out from top to bottom along

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How to measure the pulse. What will pulse waves tell

By the frequency, rhythm, filling and tension of the pulse, you can learn a lot about the state of human health. However, for this, the pulse must be able to measure.

Pulse

The heart, or rather its muscles, constantly perform rhythmic contractile movements, due to which there is an incessant movement of blood through the blood vessels, delivering oxygen and nutrients to the cells of the body.

After each heartbeat, another portion of blood passes through the arteries.

Due to the wave-like filling of blood vessels with blood, rhythmic oscillations of the walls of the arteries occur. It is these vibrations that are called the pulse.

Pulse measurement technique

To measure the pulse, place the index and middle fingers of one hand on the inside of the wrist of the other hand so that the fingertips are located on the radial artery.

With your fingers slightly pressed, move them until a pulsation of blood is found under the fingers.

Strengthen the pressure on the artery in order to press it against the surface of the radius. After that, the pulsation of blood in the artery should become clear and easily distinguishable.

To avoid unnecessary muscle tension in the arm on which the pulse is measured, place it in a comfortable position. After feeling the pulse on both hands, use the hand on which the blood pulsations are clearer to measure the pulse.

If it is not possible to measure the pulse on the wrist for a number of reasons, use the carotid artery in the lateral region of the neck or the temporal artery for research, moving slightly up and forward from the zygomatic arch.

Also suitable are the facial artery at the lower jaw at the angle of the mouth, the femoral artery at the inner thigh, the popliteal artery at the top of the popliteal fossa, the axillary artery at the lower armpit, or the ulnar artery at the medial wrist.

Armed with a stopwatch or watch, count the number of pulse waves in 1 minute. This value will be the heart rate, measured in beats per minute.

In practice, measurements are performed for 10 or 15 seconds, after which the number of pulse beats is multiplied by 6 or 4, respectively. It is possible to significantly facilitate the task of measuring the pulse using an electronic tonometer.

Simultaneously with the measurement of the pulse rate, evaluate its rhythm, tension and filling.

Pulse rate

It is one of the main parameters of the pulse characterizing the state of human health.

In a healthy adult, the normal value of the pulse rate is from 60 to 80 beats per minute, and the pulse in women, in comparison with men, is always somewhat rapid.

In trained, physically developed and healthy people, the pulse rate is usually below normal and equal to beats per minute.

In newborns, the pulse rate is approximately 140 beats per minute, in infants - 120, and in children under 10 years old - 100 beats per minute.

A too rapid or excessively slow pulse will indicate violations in the work of the heart. A pulse rate below 60 beats per minute indicates bradycardia, and a pulse rate above 90 beats per minute gives reason to talk about tachycardia.

The rhythm of the pulse, its filling and tension

The value of the pulse rhythm is determined by comparing the intervals between individual pulse shocks.

The same pulse time intervals indicate a clear and correct pulse rhythm, which in turn is an indirect indicator of the health of the human cardiovascular system.

If the time intervals through which the pulse beats occur are of different lengths, this is evidence of an arrhythmia caused by diseases or functional disorders of the heart.

Arrhythmia is atrial when the rhythm of the pulse is chaotic and paroxysmal, characterized by sudden strong heartbeats. Separately, extrasystole is isolated, which is characterized by the appearance of an extra beat in the interval.

Pulse tension is directly related to blood pressure. By the force of pressing necessary to completely compress the pulsating artery, one can judge the value of blood pressure at the moment.

The filling of the pulse is characterized by the volume of blood in the artery at the height of the pulse wave. In addition to the pulse of normal (moderate) filling, there is an empty pulse, when its palpation is difficult, a threadlike (barely perceptible) pulse and a full pulse, in which the filling exceeds the norm.

If you notice changes in its frequency, rhythm, filling or tension during the measurement of the pulse, immediately consult a cardiologist or a general practitioner.

The main characteristics of the pulse

Six basic characteristics of the pulse

Rhythm - the alternation of cardiac vibrations at regular intervals. Most often, a violation of the cycle can be caused by extrasystole (the appearance of foci that produce additional signals of contraction) or heart blockade (i.e., a violation of the conduction of nerve impulses).

Frequency

Heart rate (HR) is the number of heartbeats per minute. There are two types of deviations:

bradycardia (up to 50 beats / min) - slowing down of the heart;
tachycardia (from 90 beats / min) - an increase in the number of pulse waves.

It is calculated using a tonometer or by palpation for 1 minute. The rate of heart rate depends on age:

newborns - 130-140 beats per minute;
children under 1 year old - 120–130 beats;
from 1 to 2 years - 90-100 beats;
from 3 to 7 years - 85–95 beats;
from 8 to 14 years old - 70–80 beats;
adults from 20 to 30 years old - 60–80 beats;
from 40 to 50 years old - 75–85 beats;
from 50 years old - 85–95 beats.

Value

A large pulse (i.e., when more blood begins to be pumped through the arteries with an increased tone of the blood tract) is observed with pathologies of the aortic valve, hyperfunction of the thyroid gland.
Small. It can be caused by narrowing of the aorta, cardiac tachycardia and increased vascular elasticity.
Filiform. (i.e. when the beats are practically not felt). Associated with shock states or significant blood loss.
Intermittent. Occurs when alternating oscillations of small and large waves. Usually its occurrence is caused by severe damage to the myocardium.

Voltage

tense or hard pulse - with high pressure in the vessel;
mild - observed if the artery can be blocked without much effort.

Filling

It depends on the amount of blood ejected into the arteries. The degree of fluctuation of the walls of blood vessels depends on this. If this parameter is normal, then the pulse is considered full.

An empty pulse indicates that the ventricles are not ejecting enough fluid into the arteries.

The form

It is determined from the speed of change in the level of pressure between contraction and relaxation of the heart. There are several types of deviations from the norm:

A fast pulse occurs when a lot of blood flows from the ventricles with high elasticity of the vessels. This causes a sharp drop in pressure during diastole. It is a sign of aortic valve insufficiency, less often - thyrotoxicosis.
Slow. Characterized by low pressure drops. It is a sign of narrowing of the aortic wall or mitral valve insufficiency.
Announcer. It is observed if an additional wave passes through the vessels in addition to the main one. Its cause is a deterioration in the tone of peripheral vessels during normal myocardial function.

Pulse detection

The pulse is called wave-like, rhythmic vibrations of the walls of the arteries. These fluctuations occur as a result of rhythmic contractions of the heart. The pulse can be felt on superficial arteries by pressing them against the underlying bones. In medical practice, the pulse is usually determined on the radial artery in the lower forearm. The pulse can also be felt on the temporal, carotid, femoral, ulnar, and other arteries. Examine the pulse rate, rhythm, filling and tension. The properties of the pulse depend on the work of the heart and the condition of the walls of blood vessels. Therefore, by the nature of the pulse, one can judge the state of cardiac activity.

The pulse rate is determined by counting the number of beats per minute and entered on the temperature sheet with a red pencil.

The pulse rate at rest in an adult is equal to bpm. In children, the pulse is more frequent, in a newborn - 140 beats / min., in 3-5 year olds - about 100 beats / min., in 7-10 years of age - beats / min., in trained athletes and in the elderly - 60 bpm The pulse rate corresponds to the number of contractions of the heart. Pulse less than 60 beats per minute. called bradycardia, more often 90 - tachycardia.

Bradycardia occurs with jaundice, concussion, reduced thyroid function.

Tachycardia is observed with infectious fever. An increase in temperature by one degree speeds up the pulse by 8-10 beats / min. Tachycardia is observed with increased thyroid function, with cardiovascular insufficiency.

The rhythm of the pulse - can be correct when all pulse waves are the same and the intervals between them are equal (rhythmic pulse) and incorrect, when both the magnitude of the pulse waves and the intervals between them are different (arrhythmic pulse).

Pulse filling - is determined by the amount of blood ejected in one beat. There may be a full pulse if the volume is normal or increased, and if the volume is low, a small filling pulse.

Pulse tension - is determined by the pressure on the artery. The more force you need to expend in order to stop the blood flow in the artery, the higher the pulse voltage. A pulse of good filling and tension is called a large pulse, a pulse of weak filling and tension is called a small pulse. A pulse of very weak filling and tension is called filiform, and occurs with collapse, shock, fainting.

Nmedicine.net

The pulse is called jerky oscillations of the walls of the arteries due to changes in blood pressure in them with each contraction of the heart. The nature of the pulse depends on the activity of the heart and the condition of the arteries. Changes in the pulse easily occur with mental excitations, work, fluctuations in ambient temperature, with the introduction of various substances (alcohol, drugs) into the body.

The simplest method for examining the pulse is palpation, which is usually carried out on the palmar surface of the forearm at the base of the thumb, on the radial artery, despite its superficial placement. In this case, the patient's hand should lie freely, without tension.

The pulse can also be felt on other arteries: temporal, femoral, ulnar, etc. When examining the pulse, attention is paid to its frequency, rhythm, fillings and tensions.

How to measure the pulse?

When feeling the pulse, first of all pay attention to its frequency and count the number of pulse beats per minute. In a healthy person, the number of pulse waves corresponds to the number of heartbeats and is equal to beats per minute.

The pulse count is carried out for s, the result is multiplied by 4 or 2 and the number of pulse beats per minute is obtained. When the pulse rate is significantly changed to avoid error, count 1 minute. Recording the pulse in the medical history is done daily with a number or a pulse curve is drawn on the temperature sheet in the same way as the temperature one.

Under physiological conditions, the pulse rate depends on many factors:

1) from age (the most frequent pulse is observed in the first years of life)

2) from muscular work, in which the pulse accelerates, however, in athletes with a trained heart, the pulse rate is liquid;

3) from the time of day (during sleep, the pulse rate decreases)

4) from gender (in women, the pulse is 5-10 beats per minute more often than in men)

5) from mental emotions (with fear, anger and severe pain, the pulse accelerates).

Medicinal substances affect differently, for example, caffeine, atropine, adrenaline, alcohol speed up the pulse, digitalis slows it down.

An increase in heart rate of more than 90 beats per minute is called tachycardia. The pulse accelerates with mental arousal, physical exertion, with a change in body position. The cause of prolonged tachycardia may be an increase in body temperature. In fever, a 1°C rise in body temperature usually causes an increase in heart rate of 8-10 beats per minute. The more the pulse rate exceeds the height of body temperature, the more severe the patient's condition. A particularly alarming symptom is the combination of a drop in temperature with increasing tachycardia. Tachycardia is also one of the important signs of cardiovascular insufficiency. The pulse can reach 200 or more beats per minute.

In some febrile diseases, the pulse rate lags behind the temperature, such as inflammation of the meninges (meningitis), typhoid fever, etc.

A pulse rate less than 60 beats per minute is called bradycardia. With bradycardia, the number of pulse beats can reach 40 or less per minute. Bradycardia is observed in those recovering from severe infectious diseases, with brain diseases and with damage to the conduction system of the heart.

As with tachycardia, especially when it does not match the temperature, and with bradycardia, you need to carefully monitor the patient. Supervision consists in displaying the pulse rate curve on the temperature sheet.

Filling and tension of the pulse

The filling of the pulse is the degree of filling of the artery with blood during the systole of the heart. With good filling, we feel a high pulse wave under our fingers, and with poor filling, the pulse waves are small, poorly felt.

A full pulse is observed with a healthy heart, a poorly filled pulse with a weakening of the heart muscle, which is observed in heart diseases, as well as in infectious diseases and bleeding. A frequent, barely perceptible pulse is called thready The degree of filling can be learned to determine by frequently examining the pulse in healthy and sick people and comparing the sensations received.

Pulse tension is the degree of resistance of the artery by pressing a finger, depends on the blood pressure in the artery, which is due to the activity of the heart and the tone of the vascular network. In diseases accompanied by an increase in the tone of the artery, for example, in hypertension, the vessel can be squeezed with difficulty. On the contrary, with a sharp drop in arterial tone, for example, with collapse, it is enough just to lightly press on the artery, as the pulse disappears.

The degree of pulse tension depends on. Pulse study.

Pulse (P) is the oscillation of the artery wall caused by the ejection of blood into the arterial system.

It is characterized by frequency, rhythm, content, tension and magnitude.

The nature of the pulse depends on: 1) the magnitude and speed of the ejection of blood by the heart; 2) the state of the artery wall (elasticity); 3) arterial pulse is usually determined on the radial artery, as well as the temporal, common carotid, ulnar, femoral arteries, the dorsum of the foot and other arteries

Indications: 1) determination of the basic properties of the pulse.

Workplace equipment: 1) clock or stopwatch; 2) temperature sheet; 3) a pen with a red core.

Preparatory stage of the manipulation.

1. Give the patient a comfortable position, sitting or lying down, offer to relax his hands, while the hands and forearms should not be in weight.

The main stage of the manipulation.

2. Palpate the pulse on both hands at the same time, comparing their characteristics, which should normally be the same.

3. With the fingers of the right hand, grasp the patient's hand in the area of the wrist joint.

4. Place the first finger on the back of the forearm.

5. 2, 3, 4 - feel for the pulsating radial artery with your fingers and press it against the radius.

6. Assess the intervals between pulse waves (rhythmic pulse - if the intervals are equal to each other, if the time intervals are not the same - the pulse is arrhythmic (incorrect)).

7. Assess the filling of the pulse (determined by the volume of arterial blood forming a pulse wave, if the wave is good, felt, i.e. cardiac output is sufficient, then the pulse is full. With a decrease in circulating blood volume, a decrease in cardiac output, the pulse is empty).

8. Assess the tension by squeezing the radial artery until the pulse disappears (if the pulse disappears with moderate pressure, it is of satisfactory tension, with strong pressure, the pulse is tense).

9. By filling and tension, one can judge the magnitude of the pulse. A pulse of good filling and tension is called large, weak filling - small. If the magnitude of the pulse waves is difficult to determine, then such a pulse is called filiform.

10. Take a watch with a stopwatch and count the pulse (count for 30 seconds, multiply the result by 2 if the pulse is rhythmic).

With an arrhythmic pulse, the calculation is made for one minute on each hand. Then add up your heart rates and divide by 2.

The pulse rate of an adult healthy person is beats per minute. More than 90 beats - tachycardia, less than 60 beats - bradycardia.

The final stage of the manipulation.

11. Register the pulse rate in the temperature sheet.

12. Wash your hands with soap and running water and treat with an antiseptic.

15. Method for determining the pulse. Name the main characteristics of the pulse in normal and pathological conditions.

The pulse is a periodic expansion and contraction of the arteries, synchronous with cardiac activity.

The pulsation of the carotid, temporal, brachial, ulnar, radial, femoral, popliteal, posterior tibial and dorsal arteries of the feet is available for palpation.

The study of the pulse on the common carotid arteries should begin with the simultaneous palpation of it on both sides of the neck. The index finger of the palpating hand is placed over the apex of the lung, parallel to the clavicle, and the carotid artery is gently pressed posteriorly to the outer edge of the sternocleidomastoid muscle with the pulp of the nail phalanx. Also, the common carotid arteries are palpated at the inner edges of the sternocleidomastoid muscle at the level of the cricoid cartilage. Palpation of the carotid arteries must be done carefully.

Study of the pulse on the temporal arteries - you can palpate both temporal arteries at the same time; the pulp of the nail phalanges of the second-fourth fingers of both hands gently presses the temporal arteries to the front of the skull at the front edges and slightly above the auricles.

Examination of the pulsation of the aortic arch through the jugular fossa - the index finger of the right hand is lowered deep to the bottom of the jugular notch; with the expansion of the aortic arch or its lengthening, the finger feels pulse beats.

Examination of the pulse on the brachial artery - palpate with the pulp of the nail phalanges of the second-fourth fingers of one hand as deep as possible in the lower third of the shoulder at the inner edge of the biceps muscle of the shoulder, the second hand holds the patient's hand.

Examination of the pulse on the ulnar artery - palpate with the pulp of the nail phalanges of the second-fourth fingers of one hand in the region of the middle of the cubital fossa, the second hand - hold the patient's extended arm by the forearm.

The pulsation of the femoral artery is determined by the pulp of the nail phalanges of the second to fourth fingers below the pupart ligament 2-3 cm outward from the midline.

The study of the pulse on the popliteal artery is best done with the patient in the supine or prone position with the knee joint bent at an angleº; performed with the pulp of the nail phalanges of the second or fourth fingers, installed in the middle of the knee fossa.

Examination of the pulse on the dorsal artery of the foot - is performed by the pulp of the nail phalanges of the second to fourth fingers on the dorsum of the foot between the first and second metatarsal bones, less often - lateral to this area or directly on the bend of the ankle joint.

The pulsation of the posterior tibial artery is determined by the pulp of the nail phalanges of the second to fourth fingers in the gap between the posterior edge of the medial malleolus and the inner edge of the Achilles tendon.

It is customary to evaluate the properties of the pulse only on the radial artery.

Technique for probing the pulse on the radial artery:

The radial artery is located under the skin between the styloid process of the radius and the tendon of the internal radial muscle. The thumb is placed on the back of the forearm, and the remaining fingers are placed on the passage of the radial artery. You can not strongly squeeze the patient's hand, since the pulse wave will not be felt in the pinched artery. You should not feel the pulse with one finger, because. it is more difficult to find the artery and determine the nature of the pulse.

If the artery does not immediately fall under the fingers, they need to be moved along the radius and across the forearm, since the artery can pass outwards or closer to the middle of the forearm. In some cases, the main branch of the radial artery passes from the outside of the radius.

The study of the pulse begins with the simultaneous probing of it on both hands. If there is no difference in the properties of the pulse, they proceed to the study of the pulse on one arm. If there is a difference in the properties of the pulse, then it is studied in turn on each hand.

It is necessary to evaluate the following characteristics of the pulse:

1) the presence of a pulse;

2) the sameness and simultaneity of pulse waves on both radial arteries;

4) pulse rate in 1 minute;

6) filling the pulse;

7) the value of the pulse;

8) speed (shape) of the pulse;

9) the uniformity of the pulse;

10) correspondence of the number of pulse waves to the number of heartbeats per unit of time (in 1 minute);

11) elasticity of the vascular wall.

Normally, pulse shocks are palpable on both radial arteries.

The absence of a pulse in both upper limbs occurs with Takayasu's disease (aortoarteritis obliterans).

The absence of a pulse on the artery of one of the limbs occurs with obliterating atherosclerosis, thrombosis or embolism of the artery proximal to the artery with no pulsation.

The sameness and simultaneity of pulse waves on both radial arteries.

Normally, pulse shocks are the same and appear simultaneously on both radial arteries.

The pulse on the left radial artery may be smaller (pulsus differens) - observed in patients with severe mitral stenosis or aneurysm of the aortic arch (Popov-Saveliev symptom).

Normally, pulse shocks follow at regular intervals (correct rhythm, pulsus regularis).

1. Arrhythmic pulse (pulsus inaecqualis) - a pulse in which the intervals between pulse waves are not the same. It may be due to dysfunction of the heart:

b) conduction (atrioventricular block II degree);

2. Alternating pulse (pulsus alternans)) - a rhythmic pulse, in which the pulse waves are uneven: large and small pulse waves alternate. Such a pulse occurs in diseases accompanied by a significant weakening of the contractile function of the left ventricular myocardium (myocardial infarction, cardiosclerosis, myocarditis).

3. Paradoxical pulse (pulsus panadoxus) - a pulse when the pulse waves in the inspiratory phase decrease or disappear altogether, and are clearly palpated in the expiratory phase. This symptom occurs with constrictive and exudative pericarditis.

Pulse rate in 1 minute.

The number of pulse shocks is counted in 15 or 30 s and the result is multiplied by 4 or 2, respectively. With a rare pulse, it is necessary to count at least 1 minute (sometimes 2 minutes). In healthy adults, the pulse rate ranges from 60 to 90 per minute.

Frequent pulse (pulsus frequens) - a pulse whose frequency is more than 90 per minute (tachycardia).

Rare pulse (pulsusrarus) - a pulse whose frequency is less than 60 per minute (bradycardia).

Pulse tension is the tension of the arterial wall, which corresponds to the strength of its resistance when pressed with fingers until the pulse waves stop. The intensity of the pulse is due to the tone of the arterial wall and the lateral pressure of the blood wave (i.e. blood pressure). To determine the voltage of the pulse, the 3rd finger gradually presses on the artery until the 2nd finger ceases to feel the pulsating blood flow. Normal pulse of good tension.

Intense (hard) pulse (pulsus durus) - occurs with increased systolic blood pressure, sclerotic thickening of the artery wall, aortic insufficiency.

A soft pulse (pulsusmollis) is a symptom of low systolic blood pressure.

Pulse filling is the amount (volume) of blood that forms a pulse wave. By pressing on the radial artery with different force, they get a feeling of the volume of its filling. Healthy people have a good filling pulse.

Full pulse (pulsus plenus) is a symptom of conditions accompanied by an increase in the stroke volume of the left ventricle and an increase in the mass of circulating blood.

Empty pulse (pulsus vacuus) is a symptom of conditions accompanied by a decrease in stroke volume, a decrease in the amount of circulating blood (acute heart failure, acute vascular insufficiency, acute post-hemorrhagic anemia).

The pulse value is the amplitude of the oscillations of the arterial wall during the passage of a blood wave. The value of the pulse is determined on the basis of an assessment of its filling and tension. A large pulse is characterized by good tension and filling, a small pulse is a soft and empty pulse. Healthy people have an adequate heart rate.

Large pulse (pulsus magnus) - occurs in conditions accompanied by an increase in the stroke volume of the heart in combination with normal or reduced arterial tone (pulse pressure is increased).

Small pulse (pulsusparvus) - occurs in conditions accompanied by an increase in the stroke volume of the heart or normal stroke volume in combination with an increase in arterial tone (pulse pressure is reduced).

The speed (shape) of the pulse.

The speed (shape) of the pulse is determined by the rate of contraction and relaxation of the radial artery. Normally, the shape of the pulse is characterized by a smooth and steep rise and the same descent (normal pulse shape).

Fast or jumping pulse (pulsus celer at attus) - a pulse with a rapid rise and fall of the pulse wave, occurs with insufficiency of the aortic valves and in conditions accompanied by an increased stroke volume of the heart in combination with a normal or reduced arterial tone.

Slow pulse (pulsustardus) - a pulse with a slow rise and fall of the pulse wave, occurs with stenosis of the aortic orifice and in conditions accompanied by arterial hypertension due to increased arterial tone (diastolic blood pressure is increased).

Correspondence of the number of pulse waves to the number of heartbeats per unit of time (per 1 minute).

Normally, the number of pulse waves corresponds to the number of heartbeats per unit time (per 1 minute).

Pulse deficiency (pulsusdeficiens) - the number of pulse waves per unit time is less than the number of heartbeats, characteristic of extrasystole and atrial fibrillation.

Elasticity of the vascular wall.

Two methods are used to assess the condition of the wall of the radial artery.

1. First, with the 2nd or 3rd finger of one hand, the radial artery is pressed down so that its pulsation stops below the place of clamping. Then, with the 2nd or 3rd finger of the other hand, several careful movements are made along the artery distally (below) the place of its clamping and the state of its wall is assessed. The radial artery with an unchanged wall in a state of bleeding is not palpable (elastic).

2. With the second and fourth fingers of the palpating hand, they squeeze the radial artery, and with the 3 (middle) finger, they study the properties of its wall with sliding movements along and across it.

Characteristics of the pulse is normal:

1) pulse waves are clearly palpable;

2) pulse waves on both radial arteries are the same and simultaneous;

3) rhythmic pulse (pulsus regularis);

4) frequency per minute;

5) average in voltage, content, size and speed (shape);

7) without deficit (correspondence of the number of pulse waves to the number of heartbeats);

8) the wall of the artery is elastic.

Pathological changes in the pulse:

1) lack of pulse;

2) the pulse on both radial arteries is not the same (p. differens);

4) soft pulse (p. mollis);

5) full pulse (p. plenus);

6) empty pulse (p. vacuus);

7) large pulse (p. magnus);

8) small pulse (p. parvus);

9) rapid pulse (p. celer);

10) slow pulse (p. tardus);

11) frequent pulse (p. frequens);

12) rare pulse (p. rarus);

13) arrhythmic pulse (p. inaecqualis);

14) pulse deficit (p. deficiens);

15) paradoxical pulse (p. panadoxus);

16) alternating pulse (p.alternans);

17) threadlike pulse (p. filiformis).

Pulse (blow, push) is a jerky, periodic oscillation of the vascular wall.

Central pulse: pulse of the aorta, subclavian and carotid arteries;

Peripheral pulse: pulse of the temporal arteries and arteries of the extremities;

Capillary (precapillary) pulse;

The study of the pulse is of great clinical importance, as it allows you to obtain very valuable and objective information about the state of central and peripheral hemodynamics and the state of other organs and systems.

Pulse Properties

The properties of the pulse of the peripheral arteries depend on:

Frequency, speed and force of contraction of the left ventricle;

Stroke volume values;

Elasticity of the vascular wall;

Vessel patency (internal diameter);

Values of peripheral vascular resistance.

The quality of the pulse should be evaluated strictly according to the following scheme:

The same pulse on symmetrical arteries;

The frequency of pulse waves per minute;

The state of the vascular wall (vessel elasticity).

These 8 properties of the pulse must be known impeccably.

Pulse uniformity

In a healthy person, the pulse on the radial arteries is the same on both sides. The difference is possible only with an atypical location of the radial artery, in which case the vessel can be found in an atypical place - lateral or medial. If this fails, then pathology is assumed.

Pathological reasons for the absence of a pulse on one side or different pulse sizes on symmetrical vessels are as follows:

anomaly in the development of the vessel,
inflammatory or atherosclerotic vascular disease,
compression of the vessel by a scar,
a tumor
lymph node.

Having found a difference in the properties of the pulse, it is necessary to establish the level of damage to the vessel by examining the radial artery at an accessible level, then the ulnar, brachial, subclavian arteries.

After making sure that the pulse is the same on both hands, further research is carried out on one of them.

Pulse rate

The pulse rate depends on the heart rate. It is better to count the pulse rate in the patient's sitting position after 5 minutes of rest in order to exclude the influence of physical and emotional stress (meeting with the doctor, walking).

The pulse is counted in 30 seconds, but better in 1 minute.

In a healthy adult, the pulse rate fluctuates within beats per minute; in women, the pulse is 6-8 beats per minute more often than in men of the same age.

In asthenics, the pulse is somewhat more frequent than in hypersthenics of the same age.

In old age, in some patients, the pulse rate increases, while in some it becomes less frequent.

In tall people, the pulse is more frequent than in short people of the same sex and age.

Well-trained people have a decrease in heart rate of less than 60 beats per minute.

For each person, the pulse rate varies from the position of the body - in a horizontal position, the pulse slows down, when moving from a horizontal to a sitting position, it quickens by 4-6 beats, when standing up, it still quickens by 6-8 beats per minute. The newly adopted horizontal position again slows down the pulse.

All fluctuations in the pulse rate depend on the predominance of the sympathetic or parasympathetic division of the autonomic nervous system.

During sleep, the pulse especially slows down.
Emotional, physical stress, eating, abuse of tea, coffee, tonic drinks leads to an increase in the tone of the sympathetic nervous system and an increase in heart rate.
The phase of respiration also affects the pulse rate, on inspiration the frequency increases, on exhalation it decreases, which reflects the state of the autonomic nervous system - on inspiration the tone of the vagus decreases, on expiration it increases.

A pulse of more than 80 beats per minute is called frequent - tachysphygmia, as a reflection of tachycardia, a pulse of less than 60 - rare, bradysphygmia, as a reflection of bradycardia.

In practice, the terms tachysphygmia and bradysphygmia have not taken root, doctors use the terms tachycardia and bradycardia with these deviations in the pulse rate.

Frequent heart rate

A frequent pulse that is not provoked by physical, emotional, nutritional and drug stress (atropine, adrenaline, mezaton, etc.) most often reflects trouble in the body.

Tachycardia can be of extracardiac and cardiac origin.

Almost all cases of fever are accompanied by an increase in heart rate, an increase in body temperature by 1 degree leads to an increase in heart rate by 8-10 beats per minute.

An increase in the pulse occurs with pain, with most infectious and inflammatory diseases, with anemia, surgical diseases and surgical interventions, with thyrotoxicosis.

Tachycardia in the form of seizures is called paroxysmal tachycardia, while the pulse rate reaches beats per minute.

rare pulse

A rare pulse is noted with a significant increase in vagal tone for extracardiac reasons - intracranial trauma, some diseases of the gastrointestinal tract, liver, decreased thyroid function (myxedema), cachexia, starvation, meningitis, shock, rapid rise in blood pressure, taking digitalis preparations, beta - adrenoblockers, etc.

For cardiac reasons, a rare pulse (bradycardia) is observed with weakness of the sinus node, blockade of the conduction system, and narrowing of the aortic orifice.

The pulse rate, especially in cases of slowing down and arrhythmia, must be compared with the number of heartbeats counted in 1 minute during auscultation of the heart.

The difference between the number of heartbeats and the pulse is called pulse deficit.

Pulse Rhythm

In a healthy person, pulse waves follow at regular intervals, at regular intervals. Such a pulse is called rhythmic, regular, while the heart rate can be different - normal, rapid, slow.

A pulse with uneven intervals is called arrhythmic, irregular. In healthy adolescents and young people with labile autonomic regulation of blood circulation, respiratory sinus arrhythmia is noted. At the beginning of expiration, due to an increase in the tone of the vagus nerve, there is a temporary slowdown in the rate of heart contractions, a slowdown in the pulse rate. During inspiration, there is a weakening of the influence of the vagus and the heart rate increases slightly, the pulse quickens. When holding the breath, such respiratory arrhythmia disappears.

An arrhythmic pulse is most often caused by heart disease. It is most clearly detected in such heart rhythm disturbances as extrasystole and atrial fibrillation.

Extrasystole is a premature contraction of the heart. After a normal pulse wave, a premature small pulse wave slips under the fingers, sometimes it is so small that it is not even perceived. It is followed by a long pause, after which there will be a large pulse wave due to a large stroke volume. Then again there is an alternation of normal pulse waves.

Extrasystoles can be repeated after 1 normal beat (bigeminia), after 2 trigeminia), etc.

Another common variant of an arrhythmic pulse is atrial fibrillation. It appears with a chaotic contraction of the heart ("nonsense of the heart").

Pulse waves on the vessels have an irregular, chaotic alternation, they are also different in size due to the different stroke volume.

The frequency of pulse waves can range from 50 to 160 per minute. If atrial fibrillation begins suddenly, then they talk about its paroxysm.

An arrhythmic pulse is called in cases of its sudden increase in a person at rest, up to a frequency of beats per minute, that is, with paroxysmal tachycardia. Such an attack can just as suddenly stop. Arrhythmic include the so-called alternating or intermittent pulse, in which there is a correct alternation of large and small pulse waves. This is typical for severe myocardial diseases, a combination of hypertension with tachycardia.

An irregular pulse is also observed in other rhythm disturbances: parasystole, sick sinus syndrome, sinus node failure, atrioventricular dissociation.

Pulse voltage

This property reflects intravascular pressure and the state of the vascular wall, its tone and density.

There are no objective criteria for assessing pulse tension, the technique is being worked out empirically in the study of healthy and sick people.

The degree of pulse tension is determined by the resistance of the vessel to the pressure of the finger.

When determining tension, the third, proximal finger (the one closest to the heart) gradually presses on the artery until the distally located fingers no longer feel the pulsation.

In a healthy person with a normal pulse tension, a moderate effort is required to clamp the vessel. The pulse of a healthy person is estimated as a pulse of satisfactory tension.

If significant strengthening is required and the vascular wall has a significant resistance to clamping, then they speak of a tense, hard pulse, which is typical for hypertension of any genesis, severe sclerosis, or vasospasm.

A decrease in vessel tension, slight squeezing of the pulse indicates a soft pulse, which is observed with a decrease in blood pressure, a decrease in vascular tone.

Filling the pulse

It is estimated by the magnitude of the fluctuation of the vascular wall in systole and diastole, that is, by the difference between the maximum and minimum volumes of the artery. Filling mainly depends on the magnitude of the stroke volume and the total mass of blood, its distribution.

The degree of filling of the pulse can be judged using the following technique.

The proximal finger pinches the vessel completely, the distally located fingers feel the empty vessel, determining the state of the vascular wall. Then the pressure of the proximal finger stops, and the distal fingers feel the amount of filling of the artery. Fluctuations in the filling of the vessel from zero to the maximum reflects the filling of the vessel.

Another method for assessing the filling of the pulse is based on determining the magnitude of the fluctuation of the vascular wall from the level of diastolic filling to the level of systolic. All fingers placed on the vessel do not exert pressure on it, but only lightly touch the surface of the vessel during diastole. In systole, at the time of the passage of the pulse wave, the fingers easily perceive the magnitude of the fluctuation of the vascular wall, that is, the filling of the vessel.

In a person with normal hemodynamics, the filling of the pulse is assessed as satisfactory. With emotional and physical stress, as well as for some time (3-5 minutes) after exercise, due to an increase in stroke volume, the pulse will be full.

A full pulse is noted in patients with a hyperkinetic type of blood circulation (NCD, hypertension), as well as in aortic insufficiency. Poor filling pulse - empty pulse - patients with severe hemodynamic disorders (collapse, shock, blood loss, myocardial insufficiency) have.

Pulse value

The value of the pulse is a reflection of the relationship of such properties of the pulse as filling and tension. It depends on the magnitude of the stroke volume, the tone of the vascular wall, its ability to elastic stretch in systole and fall in diastole, on the magnitude of blood pressure fluctuations in systole and diastole.

In a healthy person with satisfactory filling and tension of the pulse, the pulse value can be described as satisfactory. However, in practice, the magnitude of the pulse is spoken only when there are deviations in the form:

Large pulse (high pulse);

Small pulse (its extreme form is filiform).

A large pulse occurs with an increased stroke volume and reduced vascular tone. The fluctuation of the vascular wall under these conditions is significant, so a large pulse is also called high.

In healthy people, such a pulse can be felt after exercise, baths, baths.

In pathology, patients with valve insufficiency, aorta, thyrotoxicosis, and fever have a large pulse. In hypertension with a large difference between systolic and diastolic pressure (large pulse pressure), the pulse will also be large.

A small stroke volume of the left ventricle gives rise to a small amplitude of oscillation of the vascular wall in systole and diastole. An increase in vascular tone also leads to a decrease in the oscillation of the vascular wall during the cardiac cycle. All this fits into the concept of a small pulse, which patients with heart defects such as narrowing of the aortic orifice, mitral valve stenosis have. A small pulse is characteristic of acute cardiovascular insufficiency.

In shock, acute heart and vascular insufficiency, massive blood loss, the pulse is so small that it is called a thready pulse.

Pulse shape

The shape of the pulse depends on the rate of change in pressure in the arterial system during systole and diastole, which is reflected in the rate of rise and fall of the pulse wave.

The shape of the pulse also depends on the rate and duration of contraction of the left ventricle, the state of the vascular wall and its tone.

In a person with normal functioning of the cardiovascular system, when assessing the pulse, one usually does not talk about the shape of the pulse, although it could be called “normal”.

As options for the shape of the pulse, fast and slow pulses are distinguished.

In healthy people, only a fast pulse can be detected after physical and emotional stress. Fast and slow pulses are found in pathology.

Fast (short, jumping) pulse

Fast (short, jumping) pulse is characterized by a steep rise, a short plateau and a sharp decline in the pulse wave. Such a wave is usually high. A fast pulse is always detected with aortic valve insufficiency, in which there is an increased stroke volume, a large force and speed of contraction of the left ventricle in a short time, a large difference between systolic and diastolic pressure (diastolic may drop to zero).

A fast pulse occurs with reduced peripheral resistance (fever), with thyrotoxicosis, some forms of hypertension, nervous excitability, and anemia.

slow pulse

Slow pulse - the opposite of a fast one, characterized by a slow rise and fall of a low pulse wave, which is due to a slow rise and fall in blood pressure during the cardiac cycle. Such a pulse is due to a reduced rate of contraction and relaxation of the left ventricle, an increase in the duration of systole.

A slow pulse is observed when there is difficulty in expelling blood from the left ventricle due to an obstruction in the path of blood outflow into the aorta, which is characteristic of aortic stenosis, high diastolic hypertension. A slow pulse will also be small due to the limitation of the magnitude of the oscillation of the vascular wall.

Dicrotic pulse

A dicrotic pulse is one of the features of the pulse shape, when a short-term slight rise is felt on the falling part of the pulse wave, that is, the second wave, but of lesser height and strength.

An additional wave occurs when the tone of the peripheral arteries is weakened (fever, infectious diseases), it expresses a reverse blood wave reflected by the closed aortic valves. This wave is the greater, the lower the tone of the arterial wall.

Dicrotic pulse reflects a decrease in peripheral vascular tone with preserved myocardial contractility.

The state of the vascular wall

The vascular wall is examined after complete clamping of the artery with a proximal finger, that is, an empty vessel is examined. Distally located fingers feel the wall by rolling through the vessel.

A normal vascular wall is either not palpable or is defined as a tender, soft, flattened band about 2–3 mm in diameter.

In old age, the vascular wall sclerotizes, becomes dense, palpable in the form of a cord, sometimes the vessel is convoluted, bumpy in the form of a rosary. A dense, poorly pulsating or non-pulsating artery occurs with Takayasu's disease (pulseless disease), which is caused by inflammation of the vascular wall, as well as vascular thrombosis.

Pulse deficit

Pulse deficit is a discrepancy between the number of heartbeats and the number of pulse waves.

This means that part of the pulse waves does not reach the periphery due to a sharply reduced stroke volume of individual heart contractions.

This happens with early extrasystoles and with atrial fibrillation.

Pulse is a jerky oscillation of the vessel wall caused by the movement of blood ejected by the heart. The properties of the pulse are determined by frequency, rhythm, tension and filling.

The pulse rate is normal from 60 to 80 beats per 1 minute. Women's heart rate is higher than men's. In newborns, the pulse reaches beats per minute, in infants - in children older than a year, then with age, the pulse gradually slows down. With fever, excitement, physical work, the pulse quickens. An increase in heart rate is called tachycardia, a slowdown is called bradycardia.

The pulse is determined in places where the arteries are located superficially and are accessible to palpation. A typical place is the radial artery in the distal third of the forearm, less often the pulse is determined on the temporal, femoral or carotid arteries. To determine the pulse, use three fingers at the same time (II-III-IV), while lightly pressing the artery so that it is not pinched, otherwise the pulse wave may disappear. You can not use the V finger, because. it has a pulsating artery, which can be misleading.

The nature of the pulse depends on the activity of the heart and the condition of the artery.

The pulse is counted for 30 seconds and then multiplied by two. In some cases, individual contractions of the heart muscle are so weak that the pulse wave does not reach the periphery, and then a pulse deficit occurs, i.e. the difference between the number of heartbeats and the number of pulse beats.

Normally, the pulse is rhythmic, i.e. pulse beats follow each other at regular intervals. In some cases, there is an arrhythmia of the pulse, as a rule, with a disease of the heart muscle and a violation of the nerve conduction of the heart. Arrhythmia can also be observed in healthy people - on inhalation and exhalation (increase and decrease), the so-called respiratory arrhythmia.

Pulse tension is the force required to compress an artery in order to stop the pulsation. By the degree of pulse tension, one can approximately judge the magnitude of the maximum arterial pressure - the higher it is, the more intense the pulse.

Pulse filling - is determined by the amount of blood that forms the pulse wave, and depends on the systolic volume of the heart. With good filling, a high pulse wave is felt under the finger, and with poor filling, the pulse is weak, the pulse wave is small, sometimes poorly distinguishable. Weak filling of the pulse indicates a weakening of the work of the heart muscle, i.e. about heart disease. A barely perceptible pulse is called thready. A thready pulse is a poor prognostic sign and indicates a serious condition of the patient.

Pulse - jerky vibrations of the walls of blood vessels resulting from the ejection of blood from the heart into the vascular system. There are arterial, venous and capillary pulses. Of greatest practical importance is the arterial pulse, usually palpable in the wrist or neck.

Pulse measurement. The radial artery in the lower third of the forearm just before its articulation with the wrist joint lies superficially and can be easily pressed against the radius. The muscles of the hand that determines the pulse should not be tense. Two fingers are placed on the artery and squeezed with force until the blood flow is completely stopped; then the pressure on the artery is gradually reduced, assessing the frequency, rhythm and other properties of the pulse.

In healthy people, the pulse rate corresponds to the heart rate and is at rest beats per minute. An increase in heart rate (more than 80 per minute in the supine position and 100 per minute in the standing position) is called tachycardia, a slowdown (less than 60 per minute) is called bradycardia. The pulse rate with the correct heart rhythm is determined by counting the number of pulse beats in half a minute and multiplying the result by two; in violation of the rhythm of cardiac activity, the number of pulse beats is counted for a whole minute. In some heart diseases, the pulse rate may be less than the heart rate - pulse deficiency. In children, the pulse is more frequent than in adults, in girls it is somewhat more frequent than in boys. The pulse is less frequent at night than during the day. A rare pulse occurs with a number of heart diseases, poisoning, and also under the influence of drugs.

Normally, the pulse quickens with physical stress, neuro-emotional reactions. Tachycardia is an adaptive reaction of the circulatory apparatus to the increased need for oxygen in the body, contributing to increased blood supply to organs and tissues. However, the compensatory reaction of a trained heart (for example, in athletes) is expressed in an increase not so much in the pulse rate as in the strength of heart contractions, which is preferable for the body.

characteristics of the pulse. Many diseases of the heart, endocrine glands, nervous and mental diseases, fever, poisoning are accompanied by increased heart rate. During palpation examination of the arterial pulse, its characteristics are based on determining the frequency of pulse beats and assessing such qualities of the pulse as rhythm, filling, tension, pitch, speed .

Pulse rate is determined by counting pulse beats for at least half a minute, and with an incorrect rhythm - for a minute.

Pulse Rhythm assessed by the regularity of the following one after another pulse waves. In healthy adults, pulse waves, like heart contractions, are noted at regular intervals, i.e. the pulse is rhythmic, but with deep breathing, as a rule, there is an increase in the pulse on inhalation and a decrease on exhalation (respiratory arrhythmia). An irregular pulse is also observed with various cardiac arrhythmias: pulse waves at the same time follow at irregular intervals.

Filling the pulse determined by the sensation of pulse changes in the volume of the palpated artery. The degree of filling of the artery depends primarily on the stroke volume of the heart, although the extensibility of the arterial wall is also important (it is the greater, the lower the tone of the artery

Pulse voltage determined by the magnitude of the force that must be applied to completely compress the pulsating artery. To do this, one of the fingers of the palpating hand squeezes the radial artery and at the same time determines the pulse distally with the other finger, fixing its decrease or disappearance. There is a tense, or hard pulse, and a soft pulse. The degree of pulse tension depends on the level of blood pressure.

Pulse height characterizes the amplitude of the pulse oscillation of the arterial wall: it is directly proportional to the magnitude of the pulse pressure and inversely proportional to the degree of tonic tension of the artery walls. With shock of various etiologies, the pulse value sharply decreases, the pulse wave is barely palpable. Such a pulse is called threadlike.

The very first actions in the provision of emergency care provide for an objective assessment of the situation and the condition of the patient, therefore, the person acting as a rescuer grabs the radial artery (temporal, femoral or carotid) in order to find out about the presence of cardiac activity and measure the pulse.

The pulse rate is not a fixed value, it varies within certain limits depending on our state at that moment. Intense physical activity, excitement, joy make the heart beat faster, and then the pulse goes beyond normal limits. True, this state does not last long, a healthy body needs 5-6 minutes to recover.

Within normal limits

The normal pulse rate for an adult is 60-80 beats per minute. what is more is called , less is called . If pathological conditions become the cause of such fluctuations, then both tachycardia and bradycardia are regarded as a symptom of the disease. However, there are other cases as well. Probably, each of us has ever encountered a situation where the heart is ready to jump out from an excess of feelings and this is considered normal.

As for the rare pulse, it is mainly an indicator of pathological changes in the heart.

The normal pulse of a person changes in various physiological states:

Slows down in sleep, and indeed in the supine position, but does not reach real bradycardia;
Changes during the day (at night, the heart beats less often, after lunch it speeds up the rhythm), as well as after eating, alcoholic beverages, strong tea or coffee, and certain drugs (heart rate rises in 1 minute);
Increases during intense physical activity (hard work, sports training);
Increases from fright, joy, anxiety and other emotional experiences. caused by emotions or intense work, almost always passes quickly and on its own, as soon as a person calms down or stops vigorous activity;
The heart rate increases with an increase in body temperature and the environment;
Decreases over the years, however, then, in old age, again slightly rises. In women with the onset of menopause, under conditions of reduced estrogen influence, more significant upward changes in the pulse may be observed (tachycardia due to hormonal disorders);
It depends on gender (the pulse rate in women is slightly higher);
It differs in especially trained people (rare pulse).

Basically, it is generally accepted that in any scenario, the pulse of a healthy person is in the range from 60 to 80 beats per minute, and a short-term increase to 90 - 100 beats / min, and sometimes up to 170-200 beats / min is regarded as a physiological norm, if it arose on the basis of an emotional outburst or intensive labor activity, respectively.

Men, women, athletes

HR (heart rate) is influenced by indicators such as gender and age, physical fitness, occupation of a person, the environment in which he lives, and much more. In general, the differences in heart rate can be explained as follows:

Men and women respond differently to different events.(the bulk of men are more cold-blooded, women are mostly emotional and sensitive), so the heart rate of the weaker sex is higher. Meanwhile, the pulse rate in women differs very little from that of men, although, if we take into account the difference of 6-8 beats / min, then the males are lagging behind, their pulse is lower.

Out of competition are pregnant women, in which a slightly increased pulse is considered normal, and this is understandable, because during the bearing of a child, the mother's body must fully satisfy the need for oxygen and nutrients for herself and the growing fetus. The respiratory organs, the circulatory system, the heart muscle undergo certain changes to perform this task, so the heart rate increases moderately. A slightly increased pulse in a pregnant woman is considered normal if, apart from pregnancy, there is no other reason for its increase.
A relatively rare pulse (somewhere near the lower limit) is noted in people who do not forget about daily physical exercise and jogging, who prefer outdoor activities (pool, volleyball, tennis, etc.), in general, leading a very healthy lifestyle and watching their figure. They say about such people: “They have a good sports uniform”, even if, by the nature of their activity, these people are far from professional sports. A pulse of 55 beats per minute at rest is considered normal for this category of adults, it’s just that their heart works economically, but in an untrained person, this frequency is regarded as bradycardia and serves as a reason for an additional examination by a cardiologist.
The heart works even more economically skiers, cyclists, runners, rowers and adherents of other sports that require special endurance, their resting heart rate can be 45-50 beats per minute. However, a long-term intense load on the heart muscle leads to its thickening, expansion of the boundaries of the heart, an increase in its mass, because the heart is constantly trying to adapt, but its possibilities, unfortunately, are not unlimited. A heart rate of less than 40 beats is regarded as a pathological condition, and eventually the so-called "sports heart" develops, which often causes the death of young healthy people.

The heart rate is somewhat dependent on height and constitution: in tall people, the heart under normal conditions works more slowly than in short relatives.

Pulse and age

Previously, the fetal heart rate was recognized only at 5-6 months of pregnancy (listened with a stethoscope), now the fetal pulse can be determined using the ultrasound method (vaginal sensor) in an embryo 2 mm in size (the norm is 75 beats / min) and as it grows (5 mm - 100 beats / min, 15 mm - 130 beats / min). During pregnancy monitoring, heart rate is usually measured from 4-5 weeks of gestation. The data obtained is compared with tabular norms Fetal heart rate by week:

Pregnancy (weeks)	Norm of heart rate (beats per 1 minute)
4-5	80-103
6	100-130
7	130-150
8	150-170
9-10	170-190
11-40	140-160

By the heart rate of the fetus, you can find out his condition: if the baby's pulse changes upward, it can be assumed that there is a lack of oxygen, but as the pulse increases, the pulse begins to decrease, and its values \u200b\u200bare less than 120 beats per minute already indicate acute oxygen starvation, which threatens with undesirable consequences up to death.

The pulse rates in children, especially newborns and preschoolers, differ markedly from the values typical for adolescence and youth. We, adults, have noticed ourselves that a small heart beats more often and not so loudly. To clearly know whether a given indicator is within the normal range, there is heart rate table by age that everyone can use:

Age	Limits of normal values (bpm)
newborns (up to 1 month of age)	110-170
from 1 month to 1 year	100-160
from 1 year to 2 years	95-155
2-4 years	90-140
4-6 years old	85-125
6-8 years old	78-118
8-10 years old	70-110
10-12 years old	60-100
12-15 years old	55-95
15-50 years old	60-80
50-60 years old	65-85
60-80 years old	70-90

Thus, according to the table, it can be seen that the rate of heart rate in children after a year tends to gradually decrease, a pulse of 100 is not a sign of pathology until almost 12 years old, and a pulse of 90 is up to 15 years of age. Later (after 16 years), such indicators may indicate the development of tachycardia, the cause of which is to be found by the cardiologist.

The normal pulse of a healthy person in the range of 60-80 beats per minute begins to be recorded from about 16 years of age. After 50 years, if everything is in order with health, there is a slight increase in heart rate (10 beats per minute for 30 years of life).

Pulse rate helps in diagnosis

Pulse diagnosis, along with temperature measurement, history taking, examination, refers to the initial stages of a diagnostic search. It would be naive to believe that by counting the number of heartbeats, you can immediately find the disease, but it is quite possible to suspect something is wrong and send a person for examination.

A low or high pulse (below or above the allowable values) often accompanies various pathological processes.

high heart rate

Knowledge of the norms and the ability to use the table will help any person to distinguish increased pulse fluctuations due to functional factors from tachycardia caused by the disease. About "strange" tachycardia may indicate symptoms that are unusual for a healthy body:

Dizziness, pre-syncope, (they say that cerebral blood flow is disturbed);
Pain in the chest caused by a violation of the coronary circulation;
visual disturbances;
Vegetative symptoms (sweating, weakness, trembling of the limbs).

Increased heart rate and palpitations can be caused by:

Pathological changes in the heart and vascular pathology (congenital, etc.);
poisoning;
Chronic bronchopulmonary diseases;
hypoxia;
Hormonal disorders;
Damage to the central nervous system;
Oncological diseases;
Inflammatory processes, infections (especially with fever).

In most cases, an equal sign is placed between the concepts of a rapid pulse and a rapid heartbeat, however, this is not always the case, that is, they do not necessarily accompany each other. In some conditions ( and , ), the number of heartbeats exceeds the frequency of pulse fluctuations, this phenomenon is called a pulse deficit. As a rule, a pulse deficit accompanies terminal arrhythmias in severe heart damage, which could be caused by intoxication, sympathomimetics, acid-base imbalance, electric shock, and other pathologies involving the heart in the process.

High pulse and pressure fluctuations

The pulse and pressure do not always proportionally decrease or increase. It would be wrong to think that an increase in heart rate will necessarily lead to an increase in blood pressure and vice versa. There are also options here:

Rapid pulse at normal pressure may be a sign of intoxication, fever. Folk and medications that regulate the activity of the autonomic nervous system during VVD, antipyretic drugs for fever and drugs aimed at reducing the symptoms of intoxication will help to reduce the pulse, in general, the impact on the cause will remove tachycardia.
Rapid pulse with high blood pressure may be the result of various physiological and pathological conditions (inadequate physical activity, severe stress, endocrine disorders, diseases of the heart and blood vessels). The tactics of the doctor and the patient: examination, finding out the cause, treatment of the underlying disease.
Low blood pressure and high heart rate can become symptoms of a very serious health disorder, for example, a manifestation of development in cardiac pathology or in case of large blood loss, and, the lower the blood pressure and the higher the heart rate, the more severe the patient's condition. Definitely: to reduce the pulse, the increase of which is caused by these circumstances, will not work on its own not only for the patient, but also for his relatives. This situation requires urgent action (call "103").

A high pulse that first appeared for no reason can be tried to calm drops of hawthorn, motherwort, valerian, peony, corvalol (what is at hand). The repetition of an attack should be a reason to visit a doctor who will find out the cause and prescribe medications that affect this particular form of tachycardia.

Low heart rate

The reasons for a low heart rate can also be functional (athletes were discussed above, when a low heart rate at normal pressure is not a sign of a disease), or stem from various pathological processes:

Vagus influences (vagus - vagus nerve), decreased tone of the sympathetic department of the nervous system. This phenomenon can be observed in every healthy person, for example, during sleep (low pulse at normal pressure),
With vegetative-vascular dystonia, in the case of some endocrine disorders, that is, in a variety of physiological and pathological conditions;
Oxygen starvation and its local effect on the sinus node;
myocardial infarction;

Toxicoinfections, poisoning with organophosphorus substances;
Peptic ulcer of the stomach and duodenum;
Traumatic brain injury, meningitis, edema, brain tumor,;
Taking digitalis preparations;
Side effect or overdose of antiarrhythmic, antihypertensive and other drugs;
Hypofunction of the thyroid gland (myxedema);
Hepatitis, typhoid fever, sepsis.

In the vast majority of cases low heart rate (bradycardia) is considered a serious pathology, which requires immediate examination to identify the cause, timely treatment, and sometimes emergency medical care (sick sinus syndrome, atrioventricular blockade, myocardial infarction, etc.).

Low pulse and high blood pressure - similar symptoms sometimes appear in hypertensive patients taking drugs to lower blood pressure, which are simultaneously prescribed for various rhythm disturbances, beta-blockers, for example.

Briefly about measuring the pulse

Perhaps, only at first glance it seems that there is nothing easier than measuring the pulse of oneself or that of another person. Most likely, this is true if such a procedure is required to be carried out in a young, healthy, calm, rested person. It can be assumed in advance that his pulse will be clear, rhythmic, of good filling and tension. Being sure that most people know the theory well and do an excellent job with the task in practice, the author will only briefly recall the technique of measuring the pulse.

You can measure the pulse not only on the radial artery, any large artery (temporal, carotid, ulnar, brachial, axillary, popliteal, femoral) is suitable for such a study. By the way, sometimes along the way you can detect a venous pulse and very rarely a precapillary one (to determine these types of pulse, you need special devices and knowledge of measurement techniques). When determining, one should not forget that in the vertical position of the body, the heart rate will be higher than in the prone position and that intense physical activity will accelerate the pulse.

To measure the pulse:

Usually, the radial artery is used, on which 4 fingers are placed (the thumb should be on the back of the limb).
You should not try to catch pulse fluctuations with only one finger - an error is surely guaranteed, at least two fingers should be involved in the experiment.
It is not recommended to press too hard on the arterial vessel, since its clamping will lead to the disappearance of the pulse and the measurement will have to be started again.
It is necessary to measure the pulse correctly within one minute, measuring for 15 seconds and multiplying the result by 4 can lead to an error, because even during this time the frequency of pulse oscillations can change.

Here is such a simple technique for measuring the pulse, which can tell a lot about a lot.

The description of the pulse is normal. Pulse of weak or strong filling. Pulse measurement technique

Six basic characteristics of the pulse

Rhythm

Frequency

Value

Voltage

Filling

The form

Factors that determine the filling of the pulse

Causes of increased filling of the pulse

Causes of weak filling of the pulse

Step-by-step measurement algorithm: how to count heart beats

Norm by age in men, women, adolescents and toddlers

Causes of increased heart rate

Why it slows down and what to do about it

What examinations can the doctor prescribe

HOW TO DO

Let's talk and teach

How to measure the pulse. What will pulse waves tell

Pulse

Pulse measurement technique

Pulse rate

The rhythm of the pulse, its filling and tension

The main characteristics of the pulse

Six basic characteristics of the pulse

Frequency

Value

Voltage

Filling

The form

Pulse detection

Nmedicine.net

How to measure the pulse?

Filling and tension of the pulse

The degree of pulse tension depends on. Pulse study.

15. Method for determining the pulse. Name the main characteristics of the pulse in normal and pathological conditions.

Pulse Properties

Pulse uniformity

Pulse rate

Frequent heart rate

rare pulse

Pulse Rhythm

Pulse voltage

Filling the pulse

Pulse value

Pulse shape

Fast (short, jumping) pulse

slow pulse

Dicrotic pulse

The state of the vascular wall

Pulse deficit

Within normal limits

Men, women, athletes

Pulse and age

Pulse rate helps in diagnosis

high heart rate

High pulse and pressure fluctuations

Low heart rate

Briefly about measuring the pulse

Video: pulse in the program “Live Healthy!”