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?

In the human body, there are three types of vessels: 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 determine the 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 heart muscle is contracting , the fullness of the vascular bed, the rhythm of heart beats.

At many pathological processes the pulse changes, the characteristic of pulse ceases to correspond to norm. This allows you to suspect that the cardiovascular system is not all right.

What parameters determine the pulse? Heart Rate Characteristics

1. Rhythm. Normally, the heart contracts at regular intervals, which means that the pulse should also be rhythmic.
2. Frequency. Pulse waves are normal as many as heart beats per minute.
3. 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.
4. Filling. Depends on the volume of blood ejected from the heart into the systole.
5. The value. This concept combines content and tension.
6. 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.

Rhythm disorders

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 of the rhythm?

Arrhythmias when the sinus node function changes (a portion of the myocardium that generates impulses leading to a contraction of the heart muscle):

1. Sinus tachycardia - an increase in the frequency of contractions.
2. Sinus bradycardia is a reduction in the frequency of contractions.
3. Sinus arrhythmia - contractions of the heart at unequal intervals of time.

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 this situation, the new pacemaker will suppress the activity of the latter and impose his rhythm of contractions on the heart.

1. Extrasystoles - the appearance of an extraordinary cardiac contraction. Depending on the location of the ectopic foci of excitation, extrasystoles are atrial, atrioventricular and ventricular.
2. 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.

Impaired 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:

1. Sinoauric blockade (impulse does not go beyond the sinus node).
2. Atrial atrial block.
3. Atrioventricular blockade (the 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).
4. 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, which set the heart rhythm with a huge frequency of contraction. Naturally, in such conditions, the heart muscle is not able to adequately contract. Therefore, this pathology (especially on the part of the ventricles) is a threat to life.

Heart rate

The 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.

There may be a discrepancy between the number of cardiac contractions 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 oscillations 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.

Voltage

Depending on the changes in this indicator, the pulse also changes. Characterization of the pulse by its voltage provides for dividing into the following varieties:

1. A firm 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.
2. 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 heartbeat.

Filling

Depending on the changes in this indicator, the following types of pulse are distinguished:

1. Full. This means that the blood supply to the arteries is sufficient.
2. 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).

The value of the pulse

This indicator combines the filling and tension of the pulse. It depends primarily on the expansion of the artery during the contraction of the heart and its decline during relaxation of the myocardium. The following types of pulse are distinguished in magnitude:

1. 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.
2. Small pulse. Blood in the vascular bed is thrown out a little, the tone of the 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).
3. Even pulse. This is how the pulse rate is normal.

The shape of pulse oscillations

According to this parameter, the pulse is divided into two main categories:

1. 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.
2. 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 orifice.

How correctly to investigate 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.

The 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, because There may be situations in which pulse fluctuations will be unequal on both hands. This may be due to squeezing the vessel from the outside (for example, a tumor) or clogging its lumen (thrombus, 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 wrap around the wrist so that 4 fingers, except the large one, are on the radial artery).

How is the pulse determined in 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 is 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 examine 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 central vessels.

A few words in conclusion

The pulse of a person (the norm by age must 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.