Characteristics of the pulse: the main indicators of the norm

Author Ольга Кияница

2018-05-18

The pulse is called the oscillation of the vascular walls, which appear in response to the contraction and relaxation of the walls of the heart. Why do they arise? Their appearance is due to the fact that blood is pumped through the vascular bed under pressure, and in response to such an effect, the elastic walls of blood vessels perform pulsating movements under the pressure of blood. In a number of cases, if the vascular wall is close to the surface of the skin, the pulsation of the artery is noticeable even visually.

The main characteristics of the pulse

What are the main parameters of this indicator of the cardiovascular system interest in the doctor? Specialists distinguish six basic characteristics of the pulse:

1. Rhythm - alternation of vibrations of the walls of arteries through equal time intervals. Normally, the pulse is rhythmic and the intervals of successive shocks are almost identical. However, for various pathologies, this indicator is violated and there is an arrhythmia (that is, alternating vibrations of the walls of the arteries occur at different time intervals).

2. Frequency - displays the number of arterial wall articulations occurring in one minute. Pulse may be rare, mild or frequent. The parameters of the rate of heart rate depend on many factors, and the norm is estimated by the age of the patient. In some heart or vessel pathologies, the heart rate and heart rate may not coincide (for example, in cases where the heart cells are not completely filled with blood).

3. Filling - reflects the volume of blood discharged into the artery from the heart chambers. Normally, the lumen of the artery is filled in full and the fluctuations of the vascular walls become more palpable - such an indicator is characterized as a "full pulse". With a poorly palpable pulse, the doctor characterizes it as "empty."

4. Voltage - is determined by the force of pressing the artery, which is necessary to completely stop the flow of blood in the lumen of the artery. This indicator depends on the level of systolic pressure. With hypertension, the pulse becomes hard (or strenuous) and effort is required to clamp the artery, and a soft pulse is said in cases where such an action is performed without special effort.

5. The value depends on the filling and the voltage. It is determined by the degree of oscillation of the arterial walls between contraction and relaxation, as well as the elasticity of the vessels. There are several types of pulse values. A small pulse is provoked by narrowing of the aorta, excessive elasticity of the vascular walls or cardiac tachycardia. Large - occurs in cases where the heart pumps more blood through over-strained blood vessels (for example, with hyperproduction of thyroid hormones or aortic valve defects). Intermittent - is caused by severe lesions of the heart muscle and appears when alternating large and small waves. The threadlike pulse is characterized by a slight palpation of strokes and occurs with massive bleeding or shock states.

6. The form - is determined only by instrumental means and displays the rate of change in the volume of the arterial lumen when the blood vessel is filled with blood. Assessing this parameter of the pulse, the doctor can characterize it as slow, fast or dicrotic.

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Heart rate table by age

Normal heart rate indicators depend on many factors: age, sex, activity (physical or emotional) or resting state, level of physical fitness or presence of diseases. The pulse rate is measured in beats occurring per minute, and the norm of this indicator is determined by age.

Normal heart rate indicators for children:

Age of child

max and min indicators

Average value

0 - 1 month

110 - 170

140

1 to 12 months

102 - 162

132

1 - 2 years

94 - 155

124

4 - 6 years

86 - 126

106

6 - 8 years

78 - 118

98

8 - 10 years

68 - 108

88

10 - 12 years

60 - 100

80

12 - 15 years

55 - 95

75

Normal pulse rate for adults:

Age

max and min indicators

Average value

Up to 50 years

60 - 80

70

50 - 60 years old

65 - 85

75

60 - 80 years

70 - 90

80

What is the pulse?

Specialists distinguish such types of pulse:

  • arterial - has the greatest diagnostic value, arises as a result of rhythmic jerky arterial wall vibrations with a change in their blood filling during the heart, characterized by rhythmicity, frequency, filling, tension, height and shape (or speed);
  • capillary (or the pulse of Quincke) - the detection of such a pulse is not the norm, since in healthy people the blood flow in the capillaries is continuous due to the work of precapillary sphincters, such a pulse is determined by the intensity of the color of the nail bed, rubbed with the fingers of the forehead skin and crushed by the cover glass of the lower lip;
  • venous - is expressed in the pulsation of the cervical jugular veins and other large venous vessels located near the heart, in the peripheral veins is present rarely, according to the sphygmogram and phlebogram can be characterized as negative or positive.

Video: Pulse. What does his silence say?

Why determine the pulse?

Pulse is one of the important parameters of the quality of physiological processes, reflecting the state of health, the level of physical fitness or the presence of diseases of the heart, vessels and other systems and organs. The indicators given above in the tables are the norm of the pulse for healthy people who are at rest. It should be remembered that any changes in the body can provoke deviations from the norm in different directions. For example, during pregnancy or with menopause there is a hormonal adjustment that can reflect on the pulse rate. In humans, the pulse rate can change under the influence of many factors.

Rapid pulse - tachycardia - can occur with the following physiological states or pathologies:

  • emotional outburst or stressful situation;
  • pregnancy;
  • climacterium;
  • hot weather or stuffy room;
  • overwork;
  • high level of physical fitness;
  • the use of products containing caffeine;
  • taking certain medicines;
  • heavy menstrual bleeding;
  • severe pain;
  • diseases of the endocrine and nervous system, blood vessels and heart, high temperature in certain infections, neoplasms, anemia, bleeding, etc.

Physiological or pathological slowing of the pulse - bradycardia - can be provoked by the following factors:

  • sleep;
  • high training of the heart muscle (in athletes, active people);
  • age changes;
  • intoxication;
  • increased intracranial pressure;
  • myocardial infarction;
  • inflammatory processes in the tissues of the heart;
  • organic heart damage;
  • peptic ulcer;
  • hypothyroidism;
  • taking certain medicines.

What are the irregularities of the rhythm?

Normally, the contractions of the heart muscle are caused by the appearance of electrical impulses emanating from the sinus node (the main driver of the heart rhythm). All abbreviations occur constantly and rhythmically, that is, almost the same time interval. A violation of the rhythm of the pulse, caused by improper electrical impulses, called arrhythmia. In such cases, the pulse becomes too slow, fast, irregular or irregular.

Provoke arrhythmias can both functional disorders and diseases. Usually the root causes of such a deviation are:

  • impairment of impulse conduction through one of the nodes of the conduction system of the heart;
  • changes in the formation of a pulse in one of the nodes.

Depending on the origin of arrhythmias are as follows:

By source of occurrence

  • atrial;
  • ventricular;
  • supraventricular;
  • atrioventricular.

By the number of sources of rhythm disturbance

  • monotopic - one source;
  • polytopic - several sources.

By the nature of the violation of the electric pulse

  • with increasing conductivity;
  • with a decrease in conductivity.

With changes in the occurrence of an impulse in the sinus node, such types of arrhythmias develop:

  • sinus bradycardia (55 or less beats per minute) - is provoked by cardiac pathologies, arterial hypotension or hypothyroidism, accompanied by dizziness, sensations of general weakness and discomfort;
  • sinus tachycardia (more than 90 beats per minute) - is caused by strong emotional outbursts, physical exertion, fever and, sometimes, heart pathologies, accompanied by a palpitation;
  • sinus arrhythmia (irregular alternation of cardiac strokes) - often detected in adolescents and children and associated with breathing (on inhalation, the pulse rate increases and expands on exhalation), usually does not require treatment;
  • syndrome of weakness of the sinus node (expressed in bradycardia or bradyarrhythmia with paroxysms of extrasystole and atrial fibrillation) is provoked by traumas and abnormalities in the functioning of the heart, by disturbances in the functioning of the autonomic nervous system or by the intake of poisonous substances and medicines, proceeds secretly or causes the onset of weakness, fainting and palpitations .

If the cells of the myocardium lose the ability to generate an electrical impulse into the action potential, then the following types of arrhythmias develop in a person:

  • extrasystole (extraordinary or premature contractions of the heart muscle, extra heart beat) - provoked by vivid emotions, autonomic dysfunctions, abuse of nicotine, caffeine and alcohol or organic heart diseases, manifested as pulsations in the epigastric region, pallor, increased sweating, oxygen deficiency and strong jerks and fading of the heart, fainting states;
  • paroxysmal tachycardia (pulse rate 140 - 240 beats per minute) - attacks occur and disappear suddenly, last from several seconds to several hours, are provoked by hypertensive disease, heart pathologies, pneumonia, sepsis, medication (quinidine, cardiac glycosides, diuretics and Ephedrine) or diphtheria, are accompanied by sensations of palpitation, weakness and presence of a lump in the throat, frequent urination and increased sweating.

Atrial fibrillation is the most dangerous form of heart rhythm disturbance. Due to this deviation from the norm, a person can develop thromboembolism, cardiac arrest and heart failure. During this disorder, a person has chest pain, heart rate, heart muscle ischemia (up to infarction), signs of atrial fibrillation on the ECG and heart failure. The following factors can provoke the development of atrial fibrillation:

  • heart disease;
  • stroke;
  • severe stress;
  • reception of high doses of ethanol;
  • overdose of certain drugs;
  • surgery.

Heart rate

The heart rate is the number of cardiac contractions per unit of time. It reflects the frequency of contractions of the ventricles of the heart in one minute and normally ranges from 60 to 80 strokes (in an adult and healthy person). Often, this indicator is confused with the pulse, while this parameter of the cardiovascular system displays the number of vibrations of the vessel walls in response to contractions of the heart. Usually, both the frequency of cardiac contractions and the pulse have approximately the same value.

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The shape of pulse oscillations

The shape of the pulse reflects the speed of the change in pressure between contraction and relaxation of the heart muscle. Depending on these parameters, doctors distinguish the following forms of pulse oscillations:

  • rapid pulse - is a sign of aortic insufficiency or thyrotoxicosis, arises from the fact that a lot of blood is pushed out of the ventricles and the pressure decreases diastole;
  • slow pulse - occurs with mitral insufficiency or narrowing of the walls of the aorta, manifested by small pressure drops;
  • dicrotic pulse - appears with impaired tone of peripheral vessels and is manifested by passage through the vessels of an additional wave of oscillations.

How to properly examine the pulse?

The arterial pulse is easiest to measure with your finger, and the venous and capillary pulse can not be determined by palpation and are measured by special techniques. In some cases for the study of the arterial pulse, the patient is assigned the following instrumental methods:

  • syphography;
  • sphygmomanometry;
  • ECG or Holter ECG;
  • pulse oximetry.

Pulse counting can be performed independently, by a close person or by a doctor. Remember, a person who is measured by the pulse must be relaxed and emotionally calm, his hand should be in a comfortable position!

Video: How to measure the pulse

Most often, the measurement is performed using the radial artery palpation on the wrist. For this, with two or four fingers, the artery is pressed so that the pads of the fingers feel the oscillations of the arterial walls. After that, time is detected (it is better to do this with the help of a stopwatch) and start counting the pulse. The number of oscillations of the arterial walls can be counted in 1 minute, and if the pulse is rhythmic, then acceleration can be measured by counting the frequency of strokes in 30 seconds and multiplying the result by 2.

Sometimes the pulse is measured on other arteries:

  • ulna - on the elbow bend or in the center of the wrist;
  • sleepy - on the neck side of the thyroid cartilage and closer to the chin;
  • axillary - at the edge of the first rib;
  • femoral - on the inner side of the thigh (closer to the lap joint);
  • temporal - on the temple just above the cheekbone.

Conclusion

It is the pulse that is one of the most important diagnostic criteria. People who are not connected with medicine usually only count the number of pulsations (for example, athletes after training). However, its full description gives the doctor the opportunity to compile a detailed picture not only of the frequency of cardiac contractions, but also about the state of blood vessels and the nature of the blood flow. In practice, usually a study of the heart rate on the carotid or radial artery.


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