Pulse Measurement

Test Overview

Your pulse is the rate at which your heart beats. Your pulse is usually called your heart rate, which is the number of times your heart beats each minute (bpm). But the rhythm and strength of the heartbeat can also be noted, as well as whether the blood vessel feels hard or soft. Changes in your heart rate or rhythm, a weak pulse, or a hard blood vessel may be caused by heart disease or another problem.

As your heart pumps blood through your body, you can feel a pulsing in some of the blood vessels close to the skin's surface, such as in your wrist, neck, or upper arm. Counting your pulse rate is a simple way to find out how fast your heart is beating.

Your doctor will usually check your pulse during a physical examination or in an emergency, but you can easily learn to check your own pulse. You can check your pulse the first thing in the morning, just after you wake up but before you get out of bed. This is called a resting pulse. Some people like to check their pulse before and after they exercise.

You check your pulse rate by counting the beats in a set period of time (at least 15 to 20 seconds) and multiplying that number to get the number of beats per minute. Your pulse changes from minute to minute. It will be faster when you exercise, have a fever, or are under stress. It will be slower when you are resting.

Why It Is Done

Your pulse is checked to:

• See how well the heart is working. In an emergency situation, your pulse rate can help find out if the heart is pumping enough blood.
• Help find the cause of symptoms, such as an irregular or rapid heartbeat (palpitations), dizziness, fainting, chest pain, or shortness of breath.
• Check for blood flow after an injury or when a blood vessel may be blocked.
• Check on medicines or diseases that cause a slow heart rate. Your doctor may ask you to check your pulse every day if you have heart disease or if you are taking certain medicines that can slow your heart rate, such as digoxin or beta-blockers (such as atenolol or propranolol).
• Check your general health and fitness level. Checking your pulse rate at rest, during exercise, or immediately after vigorous exercise can give you important information about your overall fitness level.

How To Prepare

All you need to check your pulse is a watch with a second hand or a digital stop watch. Find a quiet place, where you can sit down and are not distracted when you are learning to check your pulse.

How It Is Done

You can measure your pulse rate anywhere an artery comes close to the skin, such as in your wrist or neck, temple area, groin, behind the knee, or top of your foot.

You can easily check your pulse on the inside of your wrist, below your thumb.

• Gently place 2 fingers of your other hand on this artery.
• Do not use your thumb because it has its own pulse that you may feel.
• Count the beats for 30 seconds; then double the result to get the number of beats per minute.

You can also check your pulse in the carotid artery. This is located in your neck, on either side of your windpipe. Be careful when checking your pulse in this location, especially if you are older than 65. If you press too hard, you may become lightheaded and fall.

You can buy an electronic pulse meter to automatically check your pulse in your finger, wrist, or chest. These devices are helpful if you have trouble measuring your pulse or if you wish to check your pulse while you exercise.

How It Feels

Checking your pulse should not cause pain.

Risks

Checking your pulse should not cause problems. Be careful when checking your pulse in your neck, especially if you are older than 65. If you press too hard, you may become lightheaded and fall.

Results

Normal resting heart rate

The chart below shows the normal range of a resting heart rate (pulse rate after resting 10 minutes) in beats per minute, according to age. Many things can cause changes in your normal heart rate, including your age, activity level, and the time of day.

Your pulse usually has a strong steady or regular rhythm. Your blood vessel should feel soft. An occasional pause or extra beat is normal. Normally, your heart rate will speed up a little when you breathe deeply. You can check this normal change in your pulse rate by changing your breathing pattern while taking your pulse.

Many conditions can change your pulse rate. Your doctor will talk with you about any abnormal results that may be related to your symptoms and past health.

Fast pulse

A fast heart rate may be caused by:

• Activity or exercise.
• Anemia.
• Some medicines, such as decongestants and those used to treat asthma.
• Fever.
• Some types of heart disease.
• An overactive thyroid gland (hyperthyroidism).
• Stimulants such as caffeine, amphetamines, diet pills, and cigarettes.
• Drinking alcohol.
• Stress.

Slow pulse

A slow resting heart rate may be caused by:

• Some types of heart disease and medicine to treat heart disease.
• High levels of fitness.
• An underactive thyroid gland (hypothyroidism).

Weak pulse

A weak pulse may be caused by:

• A blood clot in your arm or leg.
• Diseases of the blood vessels (peripheral arterial disease).
• Heart disease and heart failure.

Heart rate during exercise

Many people use a target heart rate to guide how hard they exercise.

During exercise, your heart should be working hard enough for a healthy effect but not so hard that your heart is overworked. You benefit the most when your exercise heart rate is within the range of your target heart rate. You can take your pulse rate during or after exercise to see if you are exercising at your target heart rate.

Or you can wear a heart rate monitor during exercise so you do not have to take your pulse. A heart rate monitor shows your pulse rate continuously, so you see how exercise changes your heart rate.

To check your heart rate while exercising:

• After exercising for about 10 minutes, stop and take your pulse.
  • Measure your heart rate by placing two fingers gently against your wrist (don't use your thumb). If it is hard to feel the pulse in your wrist, find the artery in your neck that is just to either side of the windpipe. Press gently.
  • Count the beats for 15 seconds. Multiply the number of beats by 4. This is your beats per minute.
• Make changes in how hard you exercise so that your heart rate stays within the range of your target heart rate.

Target heart rate is only a guide. Everyone is different, so pay attention to how you feel, how hard you are breathing, how fast your heart is beating, and how much you feel the exertion in your muscles.