Your pulse starts in your heart, with your heart beat. Every heart beat causes a pulse in your arteries, similar to the ripple a stone makes when it is thrown in a pond. Your heart rate is the number of times your heart contracts (beats) in one minute.
The Source of a Pulse: the Heart
A heartbeat is a contraction of the heart's muscle, forcing blood to move through arteries. An electrical impulse causes the cardiac muscle to contract. An average healthy adult heart rate is 60 to 80 beats per minute. For older adults, normal is considered 60 to 100 beats per minute. Women generally have a higher rate than men.
A heart rate greater than 100 beats per minute is considered "tachycardia." Less than 60 is "bradycardia." In the case of well-conditioned adults, a heart rate less than 60 could be termed "athletic bradycardia," which is positive. In this case, the heart is so efficient in contracting and in meeting the needs of blood supply to the rest of the body that it is slower than normal.
Heart rate is generally affected by exercise, stress, injury and illness.
The Result of a Heartbeat: a Pulse
A pulse is the expansion and contraction of an artery caused by the ejection of blood from the left side of the heart. At certain points it can be easily felt (palpated) such as in the wrist (radial) or the neck (carotid) of adults and older children. In infants and younger children, it can be palpated in the upper arm (brachial). The PMI, or point of maximal impulse, is found on the left side of the chest, about 2 inches to the left from the end of the sternum. In thin, well-conditioned people it may be palpated easily. This point is also where an apical pulse is taken with a stethoscope.
In most cases, pulse will equal heart rate and vice versa. In the case of a pulse deficit, whereas an apical pulse is, say, 70, but a radial pulse is 50, there is a problem with blood getting to that arterial point, and medical attention should be sought.
Number in Context
Context is the key with heart rate and pulse; if you are a healthy 35-year-old and your pulse is 150 beats per minute while you are exercising and feeling fine, in most situations, that is a great heart rate. If your pulse is 150, at any adult age, and you haven't done anything strenuous, you've got something that needs to be checked out immediately by a physician.
Calculate Your Heart Rate
To calculate your heart rate, find your pulse in your inner wrist, about 2 inches down from your thumb. Count the number of times you feel the pulse against your index finger in one minute. (Or count for 15 seconds and multiply by four.) Don't use your thumb to palpate (you may feel that artery's pulse). Another way is to palpate your carotid. Do so gently. Put your index finger about an inch or two from the center of your neck to either side. You should feel a good pulse.
Whenever taking a pulse, but especially in the case of the carotid, take care not to press too hard. You may stop the blood flow. In the case of the radial pulse, press too hard and you will occlude it. In the case of the carotid, you may limit blood flow to your brain. If your other carotid has plaque buildup, you may cause a loss of consciousness.
Pulse can have quality, too. Does it feel weak and thready? Is it strong and bounding? Some radial pulses may disappear when you take a deep breath of air in (inspiration) and hold it. Because this reduces the amount of pressure in your chest cavity, your heart has an easier time pumping and normally does so with less force. Blood pressure is gauged by the force of the blood against the artery's wall.
What's Your Maximal Heart Rate?
To find your maximal heart rate for exercise purposes, subtract your age from 220. This should be the highest heart rate you reach for general conditioning purposes. Consult your doctor before any exercise and your intent to pursue a maximal heart rate. Generally, by exercising to reach your maximal heart rate, you are ensuring you will stress your heart enough to produce the benefits of a cardio workout.
- Mosby's Medical, Nursing and Allied Health Dictionary, Sixth Edition; 2001