What is pulse rate?

Structure and Functions

Pulse rate is a measure of how many times the heart beats per minute. An average pulse rate for an adult is 70–72 beats per minute (bpm), but pulse rates from 60 to 100 are within the adult range of normal. In adults, a pulse rate below 60 bpm is termed bradycardia, while a rate above 100 bpm is termed tachycardia.

The surges of pressure passing through the arterial system are palpated by placing the index and middle fingers over a pulse point. The thumb should not be used, because it has a relatively large artery that may give a false reading of the examiner’s own pulse. The fingers should exert light but firm pressure. The number of heartbeats is counted, and the pulse rate is expressed in number of beats per minute.

Pulse locations and their general uses include the radial artery (inner aspect of the wrist on the thumb side), used most commonly for routine assessment of adult pulse rates; femoral (in the groin), popliteal (behind the knee), posterior tibial (in the groove between the Achilles tendon and the tibia), and dorsalis pedis (on the instep of the foot), used for assessment of circulation in the legs; apical (at the left midclavicular line and the fifth intercostal space), used for infants and small children and for cardiovascular problems; and apical-radial (combination of apical and radial pulses), used for persons with cardiac arrhythmias.

An apical pulse is taken by listening to the heart with a stethoscope placed over the apex of the heart, which is located about three inches (7.5 centimeters) to the left of the midclavicular line. Taking an apical-radial pulse requires two persons, as one person counts the apical rate of the heart while the other person simultaneously palpates and counts the radial pulse for one full minute. All pulse points may be counted for thirty-second intervals and that number multiplied by two to arrive at the number of beats per minute. However, this method will give a false reading if the rhythm is irregular. The most accurate reading is obtained by counting the pulse for one full minute.

Disorders and Diseases

A variety of diseases and conditions affect cardiovascular function and thus influence pulse rate, including neurologic, cardiopulmonary, and renal disorders. Many factors aside from disease can influence the pulse as well. Fever, fear, anxiety, anger, and exercise will increase pulse rate, while rest and relaxation will decrease the number of beats per minute. Athletes often have a low resting pulse rate because their hearts pump very efficiently.

Bibliography

"All about Heart Rate (Pulse)." American Heart Association, October 15, 2012.

Craven, Ruth F., Constance J. Hirnle, and Sharon Jensen. Fundamentals of Nursing: Human Health and Function. 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2012.

Katz, Arnold M. Physiology of the Heart. 5th ed. Philadelphia: Lippincott Williams & Wilkins, 2010.

Malik, Marek, and A. John Camm, eds. Heart Rate Variability. New York: John Wiley & Sons, 1995.

Vorvick, Linda J., et al. "Pulse." MedlinePlus, March 22, 2013.