The pulse is determined by voltage. Heart rate and its norm by age. Permissible heart rate during pregnancy

When we say “the heart beats” or “beats,” we thereby characterize such a familiar concept as the human pulse. The fact that he reacts to internal states or external influences is the norm. The pulse quickens due to positive emotions and during stressful situations, during physical activity and during illness.

Whatever is behind the pulse rate, it is the most important biological marker of human well-being. But in order to be able to “decipher” the signals sent by the heart in the form of shocks and beats, you need to know what pulse is considered normal.

Most medical terms have their roots in Latin, so if you're wondering what a pulse is, it's worth turning to translation.

Literally, “pulse” means a push or a blow, that is, we give the correct description of the pulse by saying “knocks” or “beats.” And these beats occur due to contractions of the heart, leading to oscillatory movements of the arterial walls. They arise in response to the passage of a pulse wave through the vascular walls. How is it formed?

1. When the myocardium contracts, blood is ejected from the cardiac chamber into the arterial bed, the artery at this moment expands, and the pressure in it increases. This period of the cardiac cycle is called systole.
2. Then the heart relaxes and “absorbs” a new portion of blood (this is the moment of diastole), and the pressure in the artery drops. All this happens very quickly - describing the process of the arterial pulse takes longer than its actual course.

The greater the volume of blood expelled, the better the blood supply to the organs, so a normal pulse is the value at which blood (along with oxygen and nutrients) enters the organs in the required volume.

A person’s condition during examination can be judged by several properties of the pulse:

• frequency (number of shocks per minute);
• rhythmicity (equal intervals between beats, if they are not the same, then the heartbeat is arrhythmic);
• speed (a drop and increase in pressure in the artery; accelerated or slow dynamics are considered pathological);
• tension (the force required to stop pulsation, an example of intense heartbeat is pulse waves in hypertension);
• filling (a value composed partly of the voltage and height of the pulse wave and depending on the volume of blood in systole).

The greatest influence on pulse filling is exerted by the force of compression of the left ventricle. The graphical representation of pulse wave measurement is called sphymography.

A table of the normal human pulse by year and age is presented in the lower section of the article.

A pulsating vessel for measuring pulse rate on the human body can be felt in different areas:

• on the inside of the wrist, under the thumb (radial artery);
• in the area of ​​the temples (temporal artery);
• on the popliteal fold (popliteal);
• on the bend at the junction of the pelvis and lower limb (femoral);
• on the inside of the elbow (shoulder);
• on the neck under the right side of the jaw (sleepy).

The most popular and convenient method is measuring heart rate on the radial artery; this vessel is located close to the skin. To measure, you need to find a pulsating “vein” and press three fingers tightly against it. Using a watch with a second hand, count the number of beats in 1 minute.

Palpation points for peripheral arterial pulses on the head and neck

How many beats per minute should be normal?

The concept of normal pulse includes the optimal number of heart beats per minute. But this parameter is not a constant, that is, constant, since it depends on the age, field of activity and even the gender of a person.

The results of measuring heart rate during a patient examination are always compared with how many beats per minute the pulse should be in a healthy person. This value is close to 60-80 beats per minute in a calm state. But under certain conditions, deviations from this heart rate norm of up to 10 units in both directions are allowed. For example, it is believed that the heart rate in women is always 8-9 beats faster than in men. And among professional athletes, the heart generally works in “ergonomic mode.”

The reference point for the normal heart rate of an adult is the same 60-80 beats per minute. Such a human pulse is the norm for a state of rest, if the adult does not suffer from cardiovascular and other diseases that affect heart rate. In adults, the heart rate increases under unfavorable weather conditions, during physical exertion, and during an emotional outburst. To return a person’s pulse to normal for age, a 10-minute rest is enough; this is a normal physiological reaction. If, after rest, the heart rate does not return to normal, there is reason to consult a doctor.

If a man is engaged in intense sports training, then for him at rest even 50 beats per minute is normal. In a trained person, the body adapts to the loads, the heart muscle becomes larger, due to which the volume of cardiac output increases. Therefore, the heart does not have to make multiple contractions to ensure normal blood flow - it works slowly, but efficiently.

Men engaged in mental work may experience bradycardia (heart rate less than 60 beats per minute), but it can hardly be called physiological, since even minor stress in such men can cause the opposite condition - tachycardia (heart rate above 90 beats per minute). This negatively affects the functioning of the heart and can lead to a heart attack and other serious consequences.

To bring the heart rate back to normal according to age (60-70 beats per minute), men are recommended to balance their diet, regimen and physical activity.

The normal pulse rate for women is 70-90 beats at rest, but its indicators are influenced by many factors:

• diseases of internal organs;
• hormonal background;
• woman's age and others.

A noticeable excess of the normal heart rate is observed in women during menopause. At this time, frequent episodes of tachycardia may occur, interspersed with other arrhythmic manifestations and changes in blood pressure. Many women often get hooked on sedatives at this age, which is not always justified and not very useful. The most correct decision when the pulse deviates from the norm at rest is to visit a doctor and select supportive therapy.

Changes in heart rate in women during pregnancy in most cases are physiological in nature and do not require the use of corrective therapy. But to make sure that the condition is physiological, you need to know what the normal heart rate is for a pregnant woman.

Not forgetting that for a woman a heart rate of 60-90 is the norm, we add that when pregnancy occurs, the heart rate begins to gradually increase. The first trimester is characterized by an increase in heart rate by an average of 10 beats, and by the third trimester – up to 15 “extra” beats. Of course, these shocks are not superfluous; they are necessary for pumping the volume of circulating blood increased by 1.5 times into the circulatory system of the pregnant woman. How much a pregnant woman's pulse should be depends on what her heart rate was before pregnancy - it can be 75 or 115 beats per minute. In pregnant women in the third trimester, the pulse rate is often disturbed due to lying in a horizontal position, which is why they are recommended to sleep reclining or on their side.

The highest heart rate in humans by age is in infancy. For newborns, a pulse of 140 per minute is the norm, but by the 12th month this value gradually decreases, reaching 110 - 130 beats. A rapid heartbeat in the first years of life is explained by the intensive growth and development of the child’s body, which requires increased metabolism.

A further decrease in heart rate does not occur as actively, and the rate of 100 beats per minute is reached by 6 years of age.

Only in adolescence - 16-18 years old - does the heart rate finally reach the normal adult heart rate per minute, decreasing to 65-85 beats per minute.

What heart rate is considered normal?

Heart rate is affected not only by diseases, but also by temporary external influences. As a rule, a temporary increase in heart rate can be restored after a short rest and elimination of provoking factors. What should be the normal heart rate for a person in various conditions?

At rest

The value that is considered the normal heart rate for an adult is actually the resting heart rate.

That is, when talking about the norm of a healthy heartbeat, we always mean the value measured at rest. For an adult, this norm is 60-80 beats per minute, but under certain conditions the norm can be 50 beats (in trained people) and 90 (in women and young people).

1. The maximum heart rate is calculated as the difference between the number 220 and the number of complete years of a person. (For example, for 20-year-olds this value will be: 220-20=200).
2. Minimum heart rate value (50% of maximum): 200:100x50 = 100 beats.
3. Normal heart rate under moderate loads (70% of maximum): 200:100x70 = 140 beats per minute.

Physical activity can have different intensities - moderate and high, depending on which the heart rate of the person receiving these activities will be different.

Let us remember that for moderate physical activity the heart rate ranges from 50 to 70% of the maximum value, calculated as the difference between the number 220 and the total number of years of a person.

During high physical activity, an example of which is running (as well as speed swimming, aerobics, etc.), the heart rate is calculated according to a similar scheme. To find out what a person’s heart rate is considered normal while running, use the following formulas:

1. Find out the difference between the number 220 and a person’s age, that is, maximum heart rate: 220-30 = 190 (for 30-year-olds).
2. Determine 70% of the maximum: 190:100x70 = 133.
3. Determine 85% of the maximum: 190:100x85 = 162 beats.

The normal heart rate when running ranges from 70 to 85% of the maximum value, which is the difference between 220 and the person’s age.

The formula for calculating maximum heart rate is also useful when calculating the heart rate rate for burning fat.

Most fitness trainers use for calculations the method of the Finnish physiologist and military doctor M. Karvonen, who developed a method for determining heart rate limits for physical training. According to this method, the target zone or FBL (fat burning zone) is a heart rate ranging from 50 to 80% of your maximum heart rate.

When calculating the maximum heart rate, the norm by age is not taken into account, but age itself is taken into account. For example, let’s take the age of 40 years and calculate the heart rate rate for life-saving lifestyle:

1. 220 – 40 = 180.
2. 180x0.5 = 90 (50% of the maximum).
3. 180x0.8 = 144 (80% of the maximum).
4. The heart rate ranges from 90 to 144 beats per minute.

Why is there such a discrepancy in numbers? The fact is that the normal heart rate for training should be selected individually, taking into account fitness, well-being and other characteristics of the body. Therefore, before starting training (and during it), a medical examination is necessary.

After meal

Gastrocardiac syndrome - a noticeable increase in heart rate after eating - can be observed in various diseases of the gastrointestinal tract, cardiovascular, and endocrine systems. A pathological condition is indicated by a heartbeat that is significantly higher than normal. Is there really a norm for heart rate to increase while eating?

Strictly speaking, a slight increase in heart rate during or 10-15 minutes after a meal is a physiological condition. Food entering the stomach puts pressure on the diaphragm, which forces a person to breathe deeper and more often - hence the increase in heart rate. Exceeding the normal heart rate occurs especially often when overeating.

But even if little food is eaten, and the heart still starts beating faster, this is not always a sign of pathology. Simply, digesting food requires an increase in metabolism, and for this a slight increase in heart rate is required.

The heart rate after eating is approximately equal to the normal value during moderate physical activity.

We have already learned how to calculate it, all that remains is to compare your own pulse after eating with the norm calculated using the formula.

Heart rate table by age

To compare your own measurements with the optimum, it is useful to have on hand a table of heart rate norms by age. It shows the minimum and maximum permissible heart rate values. If your heartbeat is less than the minimum normal value, bradycardia can be suspected; if it is more than the maximum, bradycardia is possible. But only a doctor can determine this.

Table. Normal human heart rate by age.

The data are given for people without any particular pathologies and measurements taken in a state of complete rest, that is, immediately after waking up or after a 10-minute rest while lying down. Women over 45 should pay attention to a slightly elevated heart rate, which is associated with hormonal changes during menopause.

Useful video

From the following video you can find out additional information about the normal human heart rate:

Conclusion

1. Heart rate is an important physiological indicator of human health.
2. The heart rate varies depending on age, gender, fitness and other physical characteristics of the human body.
3. Temporary fluctuations in heart rate by 10-15 units can be physiological in nature and do not always require drug intervention.
4. If a person’s heart rate exceeds the norm for age by a significant number of beats per minute, it is necessary to consult a doctor and find out the cause of the deviation.

Fedorov Leonid Grigorievich

Pulse is a word that every person has heard in life. But what it is and its exact concept is not known to everyone. The characteristics of the pulse can tell a lot about the state of health, give a signal about malfunctions in it, which will help identify pathology at an early stage. You need to know all this to control your body, because the phrase “keep your finger on the pulse” is more relevant than ever.

Definition

In the general concept of this term there is a division into types of pulse. Each of them has its own normative values, which show the functioning of the entire organism.

Arterial

This is a rhythmic contraction of the walls of the arteries during the release of blood supplied by the contracting heart muscle. Pulse waves begin at the mouth of the aortic valve as the left ventricle of the heart ejects blood.

Its main wave is formed due to a surge in systolic pressure when the vascular bed expands, and when it declines, the walls take their original shape. Cyclic contractions of the myocardium create a rhythm of oscillation of the aortic surfaces, which leads to a mechanical pulse wave.

It passes first through large arteries, smoothly moving to small ones, and lastly to the capillaries.

Interesting! In the capillary network, the pulse readings are zero, which is why it is impossible to feel the pulse at the level of the arterioles, but the flow of blood in them is uniform and smooth.

Capillary

It is also called Quincke's pulse. This is the movement of capillaries, which is most often tested by pressing on the tip of the nail. Redness of the nail plate shows heart rate. Its manifestation is a deviation from the norm, because in a healthy person, the movement of blood through the capillary network should be continuous, since the precapillary sphincters work constantly.

If it appears, then we are talking about a significant fluctuation in diastolic pressure. The load prevents the precapillary sphincters from working fully. Pulse properties are observed in people with pathological aortic valve insufficiency.

Venous

The heartbeat is reflected not only in the arterial bed, but also in the venous bed. If positive, it is diagnosed. But negative is considered to be normative, but it is not present in the small and medium venous network.

If we compare venous waves with arterial ones, then the first ones are smoother, even sluggish, with a longer period of rise than fall.

Basic characteristics of pulse

There are 6 main features:

Rhythm,which shows how cardiac oscillations alternate at equal intervals of time. Failure in cyclicity is typical for - lesions with additional signals or heart block due to non-conduction of the nerve impulse.

Frequency (HR)shows how many times the heart contracts in one minute. Palpation is carried out either with a tonometer. There are 2 types of deviations:

• less than 50 beats/min - occurs with slow cardiac activity;
• more than 90 beats/min is excessive muscle pulsation.

Magnitude, which directly depends on the tension and fullness of the blood flow. It is measured by the vibrations of the artery wall with the elasticity of the vessels, systole and diastole. There are 4 types of deviations:

• large, in which a huge volume of blood is pumped in the arteries with increased tone of the bloodstream, which is typical for problems with the aortic valve and hyperfunction of the thyroid gland;
• small , which is most often provoked by narrowing of the aorta, cardiac tachycardia, excessive vascular elasticity;
• , in which it is difficult to feel the blows, this is caused by shock or severe blood loss;
• intermittent, provoked by oscillations of large and small waves, is diagnosed with severe myocardial damage.

Voltage- the force that is necessary to completely stop arterial blood flow. Directly depends on systolic pressure. There are deviations:

• tense due to high blood pressure;
• soft when the artery is blocked without effort.

Filling. This is the amount of blood that the artery ejects, which is reflected in the vibration of the vascular walls. Full pulse is the normative value of this indicator. With an empty pulse, the ventricles do not release a sufficient volume of blood into the arterial bed.

Formdepends on how quickly the pressure level changes when the heart muscle contracts and relaxes. Deviations from the norm are as follows:

• soon when the ventricles eject a lot of blood with increased elasticity of the vascular bed, which leads to a sharp decrease in pressure during the decline of the wave, characteristic of aortic valve insufficiency and thyrotoxicosis;
• slow , which is characterized by small pressure drops, which indicates narrowing of the aortic walls or mitral valve insufficiency;
• announcer , diagnosed with an additional wave, which is associated with a decrease in tone in peripheral vessels with normal myocardial functioning.

Measurement methods

Pulsometry involves examining the pulse in a convenient place, most often the wrist, where the radial artery flows.

When palpated, the pulse is felt well, because the bloodstream is close to the skin. Sometimes contractions are checked by palpating the carotid, temporal, subclavian, brachial, or femoral arteries.

To complete the picture, you need to check the heart pulse in both arms. If the rhythm is good, the check takes half a minute, and the value is multiplied by 2. Athletes use heart rate monitors during exercise to show their heart rate. The device can include different functionality, but it is irreplaceable. This technique is quite accurate and is therefore recommended by the MoH.

There are cases when heart rate measurements will not give accurate results, these include:

• hypothermia, extreme heat or prolonged exposure to sunlight;
• drinking hot food and drinks;
• smoking and alcohol;
• a quarter of an hour after intercourse;
• 30 minutes after a relaxing bath or massage;
• severe hunger;
• premenstrual and menstrual period.

Pulse rates

The value may vary depending on the age, gender and physical activity of the patient.

The normal heart rate for people of different ages can be determined from the following table.

In athletes

For people with increased physical activity, heart rate results and its standard values ​​are very important, because their health directly depends on it. Excessive overload is quite dangerous and can lead to serious consequences, including heart attack, which often occurs with arrhythmia. During physical activity, your heart rate will always be higher than at rest. When walking, this value is on average 100 beats/min, and when running it can reach up to 150.

Interesting! It's easy to check your health using your pulse. To do this, you need to go up to the 3rd floor at normal speed and measure your heart rate. At a rate of up to 100 beats/min, a person’s physical shape is considered excellent; if it is 15-20 beats above this value, then it is necessary to go in for sports to get the body in order.

For athletes, standard values ​​have been established at which the load on the body will be normal. On average, with a pulse of 100-130 beats/min, it is permissible to increase activity to values ​​of 130-150 beats/min. An indicator of 200 beats/min is considered critical and the one at which activity activity needs to be reduced, as this will negatively affect the functioning of the entire cardiovascular system.

Usually, it takes about 5 minutes for a healthy person to return his pulse after training; if this does not happen, then the cardiovascular system is not working correctly, which may be evidence of a serious pathology.

What does heart rate depend on?

Pulse characteristics may vary depending on various factors such as environment, age, physiological or pathological reasons. The gender of a person is also important, as a woman’s heart beats at a higher speed than a man’s. To summarize, heart rate largely depends on the reasons:

1. Physiological, such as load, stress, food consumption and digestion. There are drinks that have a significant effect on the pulse. These are caffeine-containing products, including Coca-Cola and alcohol. Smokers also have a faster heart rate. Sleep and monotonous work help slow down the process of ventricular fibrillation and the ejection of blood.
2. Pathological, for example, infectious diseases, hypertension, neoplasms, asthma, bronchitis, heart attack, large blood loss. Often the cause of a slow heart rate is a side effect of certain medications. If the heart is malfunctioning, then the pulse waves will be irregular, and if the veins in the arms and legs are blocked, they will be completely absent.

Possible pathologies

A certain state of a person’s pulse may indicate that a pathological process is going on in his body. There are general indicators characteristic of certain diseases.

With high heart rate

Tachycardia most often occurs with the following pathologies:

• heart disease, which even at rest gives;
• malfunction of the nervous system;
• disruption of the endocrine system;
• benign and malignant neoplasms;
• infectious diseases.

Diabetes mellitus also provokes high pulse values, which is natural with such a disruption in the production of hormones. For diabetics, this is a signal that it is necessary to take measures to improve the condition, for example, by taking the right medicine.

For high heart rate and blood pressure fluctuations

In only three cases such a condition can be considered normative:

1. Strong psycho-emotional stress, such as fear, horror, anxiety, great joy, excitement, euphoria. An excited nervous system produces adrenaline, which constricts the vascular bed, leading to increased heart rate and increased blood pressure. When emotions subside, everything returns to its original state.
2. Excessive physical activity, such as sports or hard work. For such actions, the body needs a large amount of oxygen, which it receives by increasing the pressure and contraction of the heart muscle.
3. Abuse of alcohol, coffee and strong tea. In the last two cases, the culprit is caffeine, which tones the body, and alcohol contains many toxins that lead to tension in the cardiovascular system.

But often this condition is a sign of pathology, such as a neoplasm in the adrenal glands, which begin to produce excess hormones, which is comparable to the effect of adrenaline. The pathological functioning of this organ is also characteristic of Addison's disease.

Hyperthyroidism, neurogenic and psychogenic diseases also lead to problems with pulse and blood pressure. Hypertensive patients and patients with endocrine, renal, and vascular pathologies are also at risk.

With low heart rate

Bradycardia of a pathological type is not uncommon for:

• pre-infarction and post-infarction state and the attack itself;
• inflammatory process or muscle intoxication;
• changes in blood vessels and heart due to age;
• increased intracranial pressure;
• ulcers;
• myxedema;
• hypothyroidism.

Atony also leads to disruptions in heart rate and even increases this figure to 50 beats/min. A low heart rate is the result of a disruption of the cardiac output system when the electrical impulses of the myocardium do not work correctly. A slight disruption of sinus rhythm usually does not give any special symptoms and the patient does not pay attention to it. When a healthy person’s pulse drops, this will manifest itself in:

• dizziness;
• weaknesses;
• cold sweat;
• loss of consciousness;
• in critical cases - hypoxia.

Drug-induced bradycardia is often encountered, the signs of which are some pharmaceuticals. The idiopathic form of bradycardia has no established causes, but is no less dangerous for humans, especially with pathologies of the cardiovascular system.

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

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 palpating 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:

1. Moderate pulse;
2. Full pulse;
3. Empty pulse;
4. Thready pulse.

Factors determining pulse filling

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 shortens, during which the left ventricle is filled with blood from the left atrium, therefore its quantity, and, consequently, the stroke volume, decreases with severe tachycardia.

The volume of circulating blood is the amount 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, with diabetes mellitus and diabetes insipidus.

Circulating blood volume increases:

• when the body's energy needs increase (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 conditions are reflected in the filling of the pulse.

This is a subjective value. You can learn to determine filling by regularly palpating the pulse in people with various diseases. Medical students are taught this during practical classes.

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

To determine the filling of the pulse, you must:

• place 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;
• press the artery with a finger located closer to the elbow until the pulsation stops, which is determined using the second finger located lower along the artery;
• Gradually lift the finger that has pinched the vessel until pulsation is completely restored.

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

Causes of increased pulse filling

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

In a healthy person, it can be recorded during physical activity. The higher the training, 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 heart rate of 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 typical for residents of mountainous areas.

Pathological conditions and diseases accompanied by increased pulse 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 due to lung diseases;
• chronic poisoning with copper, phosphorus, manganese, cobalt;
• Erythremia is a bone marrow tumor accompanied by the production of excess red blood cells.

Causes of weak pulse filling

A weak pulse is recorded in diseases accompanied by a decrease in cardiac output or a decrease in circulating blood volume. Possible reasons:

• acute heart failure due to 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 of functional class III - IV, accompanied by a deterioration in the systolic function of the myocardium, that is, a decrease in its contractility;
• dehydration caused by intense sweating and insufficient water intake into the body (working at high ambient temperatures);
• acute vascular insufficiency that occurs with any type of shock - anaphylactic (allergic), hemorrhagic (with rapid blood loss), traumatic, painful, etc.;
• arterial hypotension - decreased blood pressure due to hypothyroidism, adrenal insufficiency;
• anemia resulting from acute blood loss after injury, 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 excreted;
• severe renal failure;
• significant burns;
• diseases accompanied by repeated vomiting and/or prolonged intense diarrhea, for example, cholera and other intestinal infections.

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

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The very first actions in providing emergency assistance involve an objective assessment of the situation and the patient’s condition, so the person acting as a rescuer primarily grabs the radial artery (temporal, femoral or carotid) 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 condition at that time. 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 heart rate for an adult is 60-80 beats per minute, that which is greater 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. Probably, each of us has ever encountered a situation when 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 human pulse changes in various physiological states:

1. It slows down in sleep, and generally in a supine position, but does not reach real bradycardia;
2. Changes during the day (at night the heart beats less frequently, after lunch the rhythm accelerates), as well as after eating, alcoholic drinks, strong tea or coffee, some medications (heart rate increases in 1 minute);
3. Increases during intense physical activity (hard work, sports training);
4. Increases from fear, joy, anxiety and other emotional experiences. caused by emotions or intense work, almost always passes quickly and independently, as soon as the person calms down or stops vigorous activity;
5. The heart rate increases with increasing body and environmental temperature;
6. It decreases over the years, but then, in old age, it increases slightly again. In women with the onset of menopause, in conditions of reduced estrogen influence, more significant upward changes in pulse may be observed (tachycardia caused by hormonal disorders);
7. Depends on gender (the pulse rate in women is slightly higher);
8. It differs in especially trained people (slow pulse).

Basically, it is generally accepted that in any case 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 due to an emotional outburst or intense work activity, respectively.

Men, women, athletes

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

• Men and women react to different events to varying degrees(the majority 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 in men, although, if we take into account the difference of 6-8 beats/min, then males lag behind, their pulse is lower.

• Out of competition are pregnant women, in which a slightly elevated pulse is considered normal and this is understandable, because while carrying a child, the mother’s body must fully meet the need for oxygen and nutrients for itself and the growing fetus. The respiratory organs, circulatory system, and heart muscle undergo certain changes to perform this task, so the heart rate increases moderately. A slightly elevated heart rate in a pregnant woman is considered normal if, besides pregnancy, there is no other reason for its increase.
• A relatively rare pulse (somewhere near the lower limit) is observed in people who do not forget about daily exercise and jogging, who prefer active recreation (swimming pool, volleyball, tennis, etc.), in general, leading a very healthy lifestyle and watching their figure. They say about such people: “They are in good sports shape,” 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, their heart simply works economically, but in an untrained person this frequency is regarded as bradycardia and serves as a reason for 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, prolonged intense stress on the heart muscle leads to its thickening, expansion of the boundaries of the heart, and an increase in its mass, because the heart is constantly trying to adapt, but its capabilities, unfortunately, are not limitless. A heart rate of less than 40 beats is regarded as a pathological condition; ultimately, the so-called “athletic heart” develops, which often becomes the cause of death in young healthy people.

The heart rate depends somewhat on height and constitution: in tall people, the heart under normal conditions works slower than in short relatives.

Pulse and age

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

By the fetal heart rate you can determine its condition: if the baby’s pulse changes towards an increase, it can be assumed that there is a lack of oxygen, but as the pulse increases, it begins to decrease, and its values ​​​​less than 120 beats per minute already indicate acute oxygen starvation, which threatens with undesirable consequences, including death.

Heart rate norms in children, especially newborns and preschool children, differ markedly from the values ​​typical for adolescence and youth. We, adults, ourselves noticed that the little heart beats more often and not so loudly. To clearly know whether this indicator is within normal values, there is table of heart rate norms by age which everyone can use:

Thus, according to the table, it can be seen that the normal 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 of age, and a pulse of 90 until the age of 15. Later (after 16 years), such indicators may indicate the development of tachycardia, the cause of which must be found by a cardiologist.

The normal pulse of a healthy person in the range of 60-80 beats per minute begins to be recorded from approximately 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 over 30 years of life).

Pulse rate helps in diagnosis

Diagnosis by pulse, along with temperature measurement, history taking, and examination, belongs to the initial stages of the diagnostic search. It would be naive to believe that by counting the number of heartbeats, one can immediately detect the disease, but it is quite possible to suspect something is wrong and send the person for examination.

Low or high pulse (below or above acceptable values) often accompanies various pathological processes.

High heart rate

Knowledge of the norms and the ability to use the table will help any person distinguish increased pulse fluctuations caused by functional factors from tachycardia caused by disease. “Strange” tachycardia may be indicated symptoms unusual for a healthy body:

1. Dizziness, lightheadedness (indicates that cerebral blood flow is impaired);
2. Chest pain caused by impaired coronary circulation;
3. Visual disorders;
4. Autonomic symptoms (sweating, weakness, trembling of limbs).

Causes of rapid pulse and heartbeat can be:

• Pathological changes in the heart and vascular pathology (congenital, etc.);
• Poisoning;
• Chronic bronchopulmonary diseases;
• Hypoxia;
• Hormonal disorders;
• Lesions of the central nervous system;
• Oncological diseases;
• Inflammatory processes, infections (especially with fever).

In most cases, an equal sign is placed between the concepts of increased pulse and 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 heart contractions exceeds the frequency of pulse oscillations, this phenomenon is called pulse deficiency. As a rule, pulse deficiency accompanies terminal rhythm disturbances in severe heart damage, the cause of which could be intoxication, sympathomimetics, acid-base imbalance, electric shock, and other pathology involving the heart in the process.

High pulse and blood pressure fluctuations

Pulse and blood pressure do not always decrease or increase proportionally. 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:

1. Increased heart rate with normal blood pressure may be a sign of intoxication, increased body temperature. Folk remedies and medications that regulate the activity of the autonomic nervous system during VSD, antipyretic drugs for fever and medications aimed at reducing the symptoms of intoxication will help reduce the pulse; in general, influencing the cause will remove tachycardia.
2. Increased heart rate with high blood pressure may be a consequence of various physiological and pathological conditions (inadequate physical activity, severe stress, endocrine disorders, heart and vascular diseases). Tactics of the doctor and the patient: examination, determination of the cause, treatment of the underlying disease.
3. Low blood pressure and high pulse may 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 higher the heart rate, the more severe the patient’s condition. It is clear: not only the patient, but also his relatives will not be able to reduce the pulse, the increase of which is caused by these circumstances. This situation requires immediate action (call “103”).

A high pulse that first appears for no reason can be calmed down drops of hawthorn, motherwort, valerian, peony, corvalol (whatever is on hand). A recurrence of an attack should be a reason to visit a doctor, who will find out the cause and prescribe medications that specifically affect this form of tachycardia.

Low heart rate

The causes of low heart rate can also be functional (about athletes, as discussed above, when a low heart rate with normal blood pressure is not a sign of disease), or stem from various pathological processes:

• Vagal influences (vagus - vagus nerve), decreased tone of the sympathetic nervous system. This phenomenon can be observed in every healthy person, for example, during sleep (low pulse with normal pressure),
• In case of 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;

• Toxic infections, poisoning with organophosphorus substances;
• Peptic ulcer of the stomach and duodenum;
• Traumatic brain injuries, meningitis, edema, brain tumor, ;
• Taking digitalis medications;
• 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 pulse (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 block, 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 disorders, beta blockers, for example.

Briefly about heart rate measurement

Perhaps, only at first glance it seems that there is nothing simpler than measuring the pulse of yourself or another person. Most likely, this is true if such a procedure is required to be performed on a young, healthy, calm, rested person. You can assume in advance that his pulse will be clear, rhythmic, of good filling and tension. Being confident that most people know the theory well and cope well with the task in practice, the author will allow himself to only briefly recall the technique of measuring 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 you can simultaneously detect a venous pulse and very rarely a precapillary pulse (to determine these types of pulses, you need special devices and knowledge of measurement techniques). When determining, we should not forget that in an upright position of the body the heart rate will be higher than in a lying position and that intense physical activity will speed up the heart rate.

To measure 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 certainly guaranteed; at least two fingers should be used in the experiment.
• It is not recommended to put undue pressure on the arterial vessel, since squeezing it 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 pulse frequency can change.

Here is a simple technique for measuring pulse, which can tell you a lot, a lot.

Video: pulse in the program “Live Healthy!”

During the contraction of the heart, another portion of blood is pushed into the vascular system. Its impact on the wall of the artery creates vibrations, which, spreading through the vessels, gradually fade to the periphery. They are called the pulse.

What is the pulse like?

There are three types of veins and capillaries in the human body. The release of blood from the heart affects each of them in one way or another, causing their walls to vibrate. Of course, arteries, as the vessels closest to the heart, are more susceptible to the influence of cardiac output. Vibrations of their walls are well determined by palpation, and in large vessels they are even noticeable to the naked eye. That is why the arterial pulse is most significant for diagnosis.

Capillaries are the smallest vessels in the human body, but even they affect the work of the heart. Their walls vibrate in time with heart contractions, but normally this can only be determined with the help of special instruments. A capillary pulse visible to the naked eye is a sign of pathology.

The veins are so far away from the heart that their walls do not vibrate. The so-called venous pulse is transmitted vibrations from nearby large arteries.

Why measure your pulse?

What is the significance of vascular wall vibrations for diagnosis? Why is this so important?

The pulse makes it possible to judge hemodynamics, how effectively it contracts, the fullness of the vascular bed, and the rhythm of heartbeats.

In many pathological processes, the pulse changes, and the pulse characteristic no longer corresponds to the norm. This allows us to suspect that not everything is in order in the cardiovascular system.

What parameters determine the pulse? Pulse characteristics

1. Rhythm. Normally, the heart contracts at regular intervals, which means the pulse should be rhythmic.
2. Frequency. Normally, there are as many pulse waves as there are heart beats per minute.
3. Voltage. This indicator depends on the value of systolic blood pressure. The higher it is, the more difficult it is to compress the artery with your fingers, i.e. Pulse tension is high.
4. Filling. Depends on the volume of blood ejected by the heart during systole.
5. Magnitude. This concept combines filling and tension.
6. Shape is another parameter that determines the pulse. The characteristics of the pulse in this case depend on the change in blood pressure in the vessels during systole (contraction) and diastole (relaxation) of the heart.

Rhythm disorders

If there are disturbances in the generation or conduction of impulses through the heart muscle, the rhythm of heart contractions changes, and with it the pulse changes. Individual vibrations of the vascular walls begin to fall out, or appear prematurely, or follow each other at irregular intervals.

What are the types of rhythm disturbances?

Arrhythmias due to changes in the functioning of the sinus node (the area of ​​the myocardium that generates impulses leading to contraction of the heart muscle):

1. Sinus tachycardia - increased contraction frequency.
2. Sinus bradycardia - decreased contraction frequency.
3. Sinus arrhythmia - contractions of the heart at irregular intervals.

Ectopic arrhythmias. Their occurrence becomes possible when a focus appears in the myocardium with activity higher than that of the sinus node. In such a situation, the new pacemaker will suppress the activity of the latter and impose its own rhythm of contractions on the heart.

1. Extrasystole - the appearance of an extraordinary cardiac contraction. Depending on the location of the ectopic focus of excitation, extrasystoles are atrial, atrioventricular and ventricular.
2. Paroxysmal tachycardia is a sudden increase in heart rate (up to 180-240 heart beats per minute). Like extrasystoles, it can be atrial, atrioventricular and ventricular.

Impaired conduction of impulses through the myocardium (blockade). Depending on the location of the problem that prevents normal progression from the sinus node, blockades are divided into groups:

1. (the impulse does not go further than the sinus node).
2. (the impulse does not pass from the atria to the ventricles). With complete atrioventricular block (III degree), a situation becomes possible when there are two pacemakers (the sinus node and the focus of excitation in the ventricles of the heart).
3. Intraventricular block.

Separately, we should dwell on the flickering and fluttering of the atria and ventricles. These conditions are also called absolute arrhythmia. In this case, the sinus node ceases to be a pacemaker, and multiple ectopic foci of excitation are formed in the myocardium of the atria or ventricles, setting the heart rhythm with a huge contraction frequency. Naturally, under such conditions the heart muscle is not able to contract adequately. Therefore, this pathology (especially from the ventricles) poses a threat to life.

Heart rate

The resting heart rate of an adult is 60-80 beats per minute. Of course, this indicator changes throughout life. Pulse varies significantly by age.

There may be a discrepancy between the number of heart contractions and the number of pulse waves. This occurs if a small volume of blood is released into the vascular bed (heart failure, decreased amount of circulating blood). In this case, vibrations of the vessel walls may not occur.

Thus, a person’s pulse (the norm for age is indicated above) is not always determined in the peripheral arteries. This, however, does not mean that the heart does not contract either. Perhaps the reason is a decrease in ejection fraction.

Voltage

Depending on changes in this indicator, the pulse also changes. The characteristics of the pulse according to its voltage include division into the following types:

1. Firm pulse. Caused by high blood pressure (BP), primarily systolic. In this case, it is very difficult to squeeze the artery with your fingers. The appearance of this type of pulse indicates the need for urgent correction of blood pressure with antihypertensive drugs.
2. Soft pulse. The artery contracts easily, and this is not very good, because this type of pulse indicates that the blood pressure is too low. It can be due to various reasons: a decrease in vascular tone, ineffectiveness of heart contractions.

Filling

Depending on changes in this indicator, the following types of pulse are distinguished:

1. means that the blood supply to the arteries is sufficient.
2. Empty. Such a pulse occurs when the volume of blood ejected by the heart during systole is small. The causes of this condition may be heart pathology (heart failure, arrhythmias with too high heart rate) or a decrease in blood volume in the body (blood loss, dehydration).

Pulse value

This indicator combines the filling and tension of the pulse. It depends primarily on the expansion of the artery during contraction of the heart and its collapse during relaxation of the myocardium. The following types of pulse are distinguished by size:

1. Big (tall). It occurs in a situation where the ejection fraction increases and the tone of the arterial wall is reduced. At the same time, the pressure in systole and diastole is different (during one cycle of the heart it increases sharply, and then decreases significantly). The reasons leading to the occurrence of a high pulse may be aortic insufficiency, thyrotoxicosis, fever.
2. Small pulse. Little blood is released into the vascular bed, the tone of the arterial walls is high, and pressure fluctuations in systole and diastole are minimal. Causes of this condition: aortic stenosis, heart failure, blood loss, shock. In especially severe cases, the pulse value may become insignificant (this pulse is called threadlike).
3. Uniform pulse. This is how the normal heart rate is characterized.

Pulse form

According to this parameter, the pulse is divided into two main categories:

1. Fast. In this case, during systole, the pressure in the aorta increases significantly, and during diastole it quickly drops. A rapid pulse is a characteristic sign of aortic insufficiency.
2. Slow. The opposite situation, in which there is no room for significant pressure drops in systole and diastole. Such a pulse usually indicates the presence of aortic stenosis.

How to properly examine the pulse?

Probably everyone knows what needs to be done to determine what a person’s pulse is. However, even such a simple manipulation has features that you need to know.

The pulse is examined in the peripheral (radial) and main (carotid) arteries. It is important to know that with weak cardiac output in the periphery, pulse waves may not be detected.

Let's look at how to palpate the pulse in the hand. The radial artery is accessible for examination at the wrist just below the base of the thumb. When determining the pulse, both arteries (left and right) are palpated, because Situations are possible when pulse fluctuations will be different on both hands. This may be due to compression of the vessel from the outside (for example, a tumor) or blockage of its lumen (thrombus, atherosclerotic plaque). After comparison, the pulse is assessed on the arm where it is better palpated. It is important that when examining pulse fluctuations, there is not one finger on the artery, but several (it is most effective to clasp your wrist so that 4 fingers, except the thumb, are on the radial artery).

How is the pulse in the carotid artery determined? If the pulse waves at the periphery are too weak, the pulse in the great vessels can be examined. The easiest way is to try to find it on the carotid artery. To do this, two fingers (index and middle) must be placed on the area where the indicated artery is projected (at the anterior edge of the sternocleidomastoid muscle above the Adam's apple). It is important to remember that it is impossible to examine the pulse on both sides at once. Pressure of two carotid arteries can cause circulatory problems in the brain.

The pulse at rest and with normal hemodynamic parameters is easily determined both in peripheral and central vessels.

A few words in conclusion

(the age norm must be taken into account during the study) allows us to draw conclusions about the state of hemodynamics. Certain changes in the parameters of pulse fluctuations are often characteristic signs of certain pathological conditions. That is why pulse examination is of great diagnostic importance.