Pulse rate

Original Editor - Ayelawa Samuel Top Contributors - Ayelawa Samuel and Leana Louw  

Introduction

Pulse wave .jpg

Pulse/heart rate is the wave of blood in the artery created by contraction of the left Ventricle during a cardiac cycle. The strength or amplitude of the pulse reflects the amount of blood ejected with myocardial contraction (stroke volume). Normal pulse rate range for an adult is between 60-100 beats per minute. A well-trained athlete may have a resting heart rate of 40 to 60 beats per minute, according to the American Heart Association (AHA).[1]

Types of Pulse rate

  • Peripheral pulses: Pulses that can be felt at the periphery of the body by palpating an artery over a bony prominence.
    • Examples are carotid, radial and popliteal pulses
  • Apical pulses: It is a central pulse located on the apex of the heart that is monitored using a stethoscope.[2]

Parameters of Pulses

  • Rate: Number of pulsation which could be bradycardia (<60/minute) or rachycardia (>100/minute)
  • Rhythm: Time interval between pulse beats[2]

Factors that Influence Heart Rate

  • Age
  • Sex
  • Emotions/stress
  • Exercise
  • Medication[2]

Pulse site

  • Temporal
  • Carotid
  • Brachial
  • Radial
  • Femoral
  • Popliteal
  • Dorsalis pedis[2]

Indications of elevated pulse (tachycardia)

  • Heart related conditions such as high blood pressure
  • Poor blood supply to the myocardium due to coronary artery disease
  • Thyroid disease (e.g. hyperthyroidism)
  • Electrolyte imbalance
  • Alcohol use
  • Emotional stress[3]

Indication for reduced pulse rate (bradycardia)

  • Infection (e.g. myocarditis)
  • Complication of heart surgery
  • Hypothyroidism
  • Medication
  • Inflammatory diseases such as rheumatic fever[4]

Physiotherapy Management

The role of the physiotherapist is to monitor the heart rate during exercise, the intensity and safe exercise level. The pulse rate must be taking into account to determine the level of intensity exercise the patient can bear (light vs moderate vs heavy exercise intensity zone).[5].

References

  1. Live Science. What is normal heart rate? Available from: https://www.livescience.com/42081-normal-heart-rate.html (accessed 03/02/2020).
  2. 2.0 2.1 2.2 2.3 Susan B, Thomas J, George D. Physical Rehabilitation Sixth edition. USA: F.A. Davis 2014.
  3. Medtronic. About tachycardia (fast heartbeat). Available from: https://www.medtronic.com/au-en/your-health/conditions/fast-heartbeat.html (accessed 03/02/2020).
  4. Mayoclinic. Bradycardia. Available from: https://www.mayoclinic.org/diseases-conditions/bradycardia/symptoms-causes/syc-20355474 (accessed 03/02/2020).
  5. ATI Physical Therapy. Target Heart Rate and Exercise Available from: https://www.atipt.com/news/target-heart-rate-and-exercise (accessed 03/02/2020).