Pulse

• Alternative Names

  Heart rate; Heart beat

• How the test is performed

  The pulse is measured at the:

  • Back of the knees
  • Groin
  • Neck
  • Temple
  • Top or inner side of the foot
  • Wrist

  In these areas, an artery passes close to the skin.

  To measure the pulse at the wrist, place the index and middle finger over the underside of the opposite wrist, below the base of the thumb. Press firmly with flat fingers until you feel the pulse.

  To measure the pulse on the neck, place the index and middle finger just to the side of the Adam's apple, in the soft, hollow area. Press firmly until you locate the pulse.

  Once you find the pulse, count the beats for 1 full minute, or for 30 seconds and multiply by 2. This will give the beats per minute.

• How to prepare for the test

  To determine the resting heart rate, you must have been resting for at least 10 minutes. Take the exercise heart rate while you are exercising.

• How the test will feel

  There is a slight pressure from the fingers.

• Why the test is performed

  Measuring the pulse can give very important information about your health. Any change from normal heart rate can indicate a medical condition. Fast pulse may signal an infection or dehydration. In emergency situations, the pulse rate can help determine if the patient's heart is pumping.

  The pulse measurement has other uses as well. During exercise or immediately after exercise, the pulse rate can give information about your fitness level and health.

• Normal Values

  For resting heart rate:

  • Newborn infants: 100 - 160 beats per minute
  • Children 1 to 10 years: 70 - 120 beats per minute
  • Children over 10 and adults (including seniors): 60 - 100 beats per minute
  • Well-trained athletes: 40 - 60 beats per minute
• What abnormal results mean

  Resting heart rates that are consistently high (tachycardia) may indicate a problem, and you should consult a health care provider. Discuss resting heart rates that are below the normal values (bradycardia) with your health care provider.

  Also, discuss a pulse that is very firm (bounding pulse) and that lasts for more than a few minutes with your health care provider. An irregular pulse can also indicate a problem.

  A pulse that is hard to feel may indicate blockages in the artery. These blockages are common in people with diabetes or atherosclerosis from high cholesterol. Your health care provider may order a test known as a Doppler study to evaluate this potentially serious situation.

  See also: Heartbeat sensations

• References

  Seidel HM, Ball JW, Dains JE, Benedict GW. Mosby's Guide to Physical Examination. 6th ed. Philadelphia, Pa: Mosby; 2007.

  Fang JC, O'Gara PT. The history and physical examination: an evidence-based approach. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier;2007: chap 11.

Review Date: 2/22/2009

Reviewed By: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.