A pulse is the rhythmic throbbing felt in arteries, caused by the heart pumping blood through the circulatory system. It serves as a fundamental vital sign, offering insights into cardiovascular health. Beyond merely counting beats, pulse characteristics reveal important information about heart function and overall well-being.
Assessing the Basic Pulse
Locating a pulse involves finding an artery close to the skin’s surface. The radial artery in the wrist and the carotid artery in the neck are common sites for pulse assessment. To find the radial pulse, place the tips of your index and middle fingers on the inside of the wrist, below the base of the thumb, applying light pressure against the bone. For the carotid pulse, place these fingers gently in the groove of the neck, beside the windpipe. Avoid pressing too hard, which can block blood flow, and never press on both carotid arteries simultaneously, as this can lead to dizziness or fainting.
Once the pulse is located, basic measurements include its rate and rhythm. Pulse rate is the number of beats per minute; for healthy adults at rest, it is typically 60 to 100 beats per minute (bpm). Athletes, due to their cardiovascular fitness, may have a lower resting heart rate, sometimes as low as 40 bpm. Pulse rhythm refers to beat regularity. A normal pulse is regular, with consistent intervals; an irregular pulse might indicate a variation in the heart’s electrical signals.
Describing Pulse Characteristics
Beyond rate and rhythm, the quality of a pulse provides further details about cardiovascular function. Amplitude, also known as strength or volume, describes the force of the pulse wave felt against the fingertips. Descriptors for amplitude range from “bounding” (very strong, possibly visibly throbbing) to “strong” or “normal,” and down to “weak” or “thready” (faint, difficult to palpate). An “absent” pulse indicates no palpable beat. The force of the pulse reflects the volume of blood pumped with each heartbeat and the elasticity of the arteries.
Contour or waveform relates to the pulse wave’s shape as it rises and falls. A normal pulse has a brisk, smooth upstroke. Variations include a “slow-rising” pulse, where the upstroke feels delayed, or a “dicrotic” pulse. A dicrotic pulse has two palpable pulsations per heartbeat, with the second, weaker one occurring during diastole (the heart’s resting phase). This secondary wave is often due to reflected pressure waves within the arterial system.
Symmetry involves comparing pulses on both sides of the body. For example, comparing the strength and timing of the radial pulses in both wrists can reveal differences. Asymmetrical pulses, where one side feels significantly different from the other, can suggest a localized issue affecting blood flow to that limb or a more widespread vascular condition.
What Pulse Quality Can Reveal
Variations in pulse quality can offer insights into potential health conditions, though they are not diagnostic on their own. A “bounding” pulse (strong and powerful) might suggest conditions like high blood pressure, fever, anxiety, or hyperthyroidism. It can also indicate an increased volume of blood ejected by the heart, as seen in conditions like aortic regurgitation or fluid overload. Conversely, a “weak” or “thready” pulse (faint and difficult to feel) may point to low blood pressure, reduced blood volume (hypovolemic shock), dehydration, or heart failure, indicating the heart is not pumping effectively.
An irregular rhythm, where beats are not evenly spaced, can be a sign of arrhythmias (abnormal heart rhythms). These irregularities range from benign variations to more serious conditions affecting the heart’s electrical system. Asymmetry between pulses on different sides of the body can indicate blockages or narrowing in the arteries, such as those caused by atherosclerosis, or other vascular issues like aortic dissection.
Pulse quality is just one piece of a comprehensive health assessment. Any observed changes should be considered within the context of other symptoms, medical history, and overall health status. Significant, persistent, or concerning changes, especially when accompanied by symptoms like chest pain, shortness of breath, dizziness, or fainting, warrant prompt medical evaluation. Only a doctor can accurately interpret these findings and provide a diagnosis or recommend appropriate treatment.