Pulse: pulse characteristic, heart rate table by age
During the contraction of the heart into the vascular system, another portion of blood is expelled. Striking it into the wall of the artery creates oscillations, which, spreading through the vessels, gradually fade to the periphery. They are called the pulse.
What is the pulse?
There are three types of vessels in the human body: arteries, veins and capillaries. The release of blood from the heart somehow affects each of them, causing their walls to oscillate. Of course, the arteries, which are closest to the heart, are more susceptible to cardiac output. The vibrations of their walls are well defined by palpation, and in large vessels even visible 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 reflect the work of the heart. Their walls oscillate in time with cardiac contractions, but normally it can be determined only with the help of special devices. Noticeable to the naked eye capillary pulse - a sign of pathology.
The veins are so far away from the heart that their walls do not oscillate. The so-called venous pulse is the transfer oscillations from closely located large arteries.
Why define a pulse?
What is the significance for the diagnosis of vascular wall fluctuations? Why is it so important?
Pulse allows you to judge hemodynamics, how effectively the cardiac muscle is contracting, the fullness of the vascular bed, the rhythm of heart beats.
With many pathological processes, the pulse changes, the pulse characteristic ceases to correspond to the norm. This allows you to suspect that the cardiovascular system is not all right.
What parameters determine the pulse? Heart Rate Characteristics
- Rhythm. Normally, the heart contracts at regular intervals, which means that the pulse should also be rhythmic.
- Frequency. Pulse waves are normal as many as heart beats per minute.
- Voltage. This indicator depends on the magnitude of systolic blood pressure. The higher it is, the harder it is to squeeze the artery with your fingers;the pulse voltage is high.
- Filling. Depends on the amount of blood thrown out by the heart into the systole.
- Value. This concept combines content and tension.
- The form is another parameter that determines the pulse. The characteristic of the pulse in this case depends on the change in arterial pressure in the vessels during systole( contraction) and diastole( relaxation) of the heart.
Violations of the rhythm
If the generation or pulse of the heart muscle is disturbed, the rhythm of the contractions of the heart changes, and with it the pulse also changes. Individual oscillations of the vascular walls begin to fall out, or appear prematurely, or follow one another at unequal intervals of time.
What are the irregularities in rhythm?
Arrhythmias when the sinus node function changes( a portion of the myocardium that generates impulses leading to a contraction of the heart muscle):
- Sinus tachycardia - an increase in the frequency of contractions. Sinus bradycardia is a reduction in the frequency of contractions.
- Sinus arrhythmia - contractions of the heart at unequal intervals.
Ectopic arrhythmias. Their occurrence becomes possible with the appearance of a focus 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 his rhythm of contractions on the heart.
- Extrasystole - appearance of an extraordinary cardiac contraction. Depending on the localization of the ectopic focus of excitation, extrasystoles are atrial, atrioventricular and ventricular.
- Paroxysmal tachycardia is a sudden increase in the rhythm( up to 180-240 beats per minute).Like extrasystoles, it can be atrial, atrioventricular and ventricular.
Disruption of impulse conduction on the myocardium( blockade).Depending on the localization of the problem preventing the normal movement of the nerve impulse from the sinus node, the blockades are divided into groups:
- Sinoauric blockade( pulse does not go beyond the sinus node).
- Atrial atrial block.
- Atrioventricular block( pulse does not pass from the atria to the ventricles).With complete atrioventricular blockade( grade III), a situation becomes possible where there are two pacemakers( a sinus node and a focus of excitation in the ventricles of the heart).
- Intraventricular blockade.
Separately, we should focus on the flicker and flutter of the atria and ventricles. These conditions are also called absolute arrhythmia. The sinus node in this case ceases to be the driver of the rhythm, and in the myocardium of the atria or ventricles, multiple ectopic foci of excitation are formed, giving the heart a rhythm with a huge frequency of contraction. Naturally, in such conditions, the heart muscle can not adequately shrink. Therefore, this pathology( especially on the part of the ventricles) poses a threat to life.
Pulse at rest in an adult is 60-80 beats per minute. Of course, this indicator varies throughout life. Pulse by age is significantly different.
Heart rate( beats per minute)
1st month of life
1 month - 1 year
1 to 2 years
90 to 100
3 to 7 years
8 - 14 years
70 - 80
20 - 30 years
60 - 80
40 - 50 years
75 - 85
More than 50 years old
85 - 95
There may be a discrepancy between the number of heartbeats and the number of pulse waves. This occurs if a small volume of blood is discharged into the vascular bed( heart failure, a decrease in the amount of circulating blood).In this case, the oscillation of the walls of the vessels may not occur.
Thus, the pulse of a person( the age norm is indicated above) is not always determined on the peripheral arteries. This, however, does not mean that the heart also does not contract. Perhaps the reason is the reduction in the ejection fraction.
Depending on the changes in this parameter, the pulse also changes. The pulse characteristic for its voltage provides for dividing into the following varieties:
- Hard pulse. Due to high blood pressure( BP), primarily systolic. It is very difficult to squeeze the artery with your fingers in this case. The appearance of this type of pulse indicates the need for urgent correction of AD with antihypertensive drugs.
- Soft pulse. The artery contracts easily, and this is not very good, because this type of pulse indicates a too low blood pressure. It can be due to various reasons: a decrease in the volume of circulating blood, a decrease in the tone of the vessels, inefficiency of the heartbeats.
Depending on the changes in this indicator, the following types of pulse are distinguished:
- Full. This means that the blood supply to the arteries is sufficient.
- Empty. Such a pulse arises with a small volume of blood ejected from the heart into the systole. The causes of this condition can be heart pathology( heart failure, arrhythmias with too high heart rate) or a decrease in blood volume in the body( blood loss, dehydration).
This indicator combines the filling and tension of the pulse. It depends first of all on the expansion of the artery during the contraction of the heart and the decrease of it in the relaxation of the myocardium. The following types of pulse are distinguished in magnitude:
- Large( high).It occurs in a situation where an increase in the ejection fraction occurs, and the tonus of the arterial wall is reduced. In this case, the pressure in the systole and diastole is different( in one cycle of the heart it rises sharply, and then significantly decreases).Causes leading to the emergence of a large pulse, may be aortic insufficiency, thyrotoxicosis, fever.
- Small pulse. Blood in the vascular bed is thrown out a little, the tone of arterial walls is high, pressure fluctuations in systole and diastole are minimal. The causes of this condition: stenosis of the aortic estuary, heart failure, blood loss, shock. In especially severe cases, the pulse value may become insignificant( such a pulse is called filamentary).
- Uniform pulse. This is how the pulse rate is normal.
Pulse oscillation form
By this parameter, the pulse is divided into two main categories:
- Fast. In this case, during systole, the pressure in the aorta is significantly increased, and in diastole falls rapidly. A rapid pulse is a characteristic sign of aortic insufficiency.
- Slow. The opposite situation, in which there is no place for significant differences in pressure in systole and diastole. Such a pulse usually indicates the presence of stenosis of the aortic aorta.
How to properly examine the pulse?
Probably everyone knows what needs to be done to determine what kind of pulse a person has. However, even such simple manipulation has features that you need to know.
Pulse is examined on the peripheral( radial) and trunk( carotid) arteries. It is important to know that with a weak cardiac output at the periphery, pulse waves can not be detected.
Consider how to palpate the pulse on the arm. The radial artery is available for examination on the wrist immediately below the base of the thumb. When determining the pulse, both arteries( left and right) are palpated, becausethere are situations where the pulse fluctuations will be different on both hands. This may be due to squeezing the vessel from the outside( for example, a tumor) or clogging its lumen( a thrombus, an atherosclerotic plaque).After comparing, the pulse is evaluated on the arm where it is best palpated. It is important that when examining pulse fluctuations, there is not one finger on the artery, but several( most effectively wrapping the wrist so that 4 fingers, except the large one, are on the radial artery).
How is the pulse determined on the carotid artery? If the pulse waves are too weak at the periphery, it is possible to investigate the pulse on the main vessels. The easiest way to try to find it on the carotid artery. To do this, two fingers( index and middle) must be placed on the area where this artery is projected( at the anterior edge of the nodding muscle above the Adam's apple).It is important to remember that it is impossible to investigate the pulse from both sides at once. Pressing two carotid arteries can cause blood circulation disorders in the brain.
Pulse at rest and with normal hemodynamic parameters is easily determined both on peripheral and on central vessels.
A few words in conclusion
The human pulse( the age norm must always be taken into account in the study) allows us to draw conclusions about the state of hemodynamics. These or other changes in the parameters of pulse oscillations are often characteristic of certain pathological conditions. That is why the study of the pulse has an important diagnostic value.