Why do we measure heart rate via pulse?

[sommerwing]

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When I measure my heart rate, I just put my hand to my chest and take it that way. I was wondering why we have these roundabout ways (arteriole pulses) to measure the HR.

My heart beat is also stronger than my arteriole pulse. So, it's even easier in that sense.

 

[thumbz]

Because you'll have a tough time convincing every female patient you see that they need to get groped so you can figure out they're at 70 BPM

 

[sommerwing]

Oh sorry, I mostly meant outside the clinic (should have been more clear).

Every runner I've seen stops and checks via radial or carotid.

 

[Bangersandmash]

Oh sorry, I mostly meant outside the clinic (should have been more clear).

Every runner I've seen stops and checks via radial or carotid.

How would you react to a runner who was groping themselves in the middle of a park or road?

 

[SpecterGT260]

When I measure my heart rate, I just put my hand to my chest and take it that way. I was wondering why we have these roundabout ways (arteriole pulses) to measure the HR.

My heart beat is also stronger than my arteriole pulse. So, it's even easier in that sense.

you're likely quite thin. Feeling it through the ribs is not very reliable. radial and carotid pulses are pretty easy to locate and are pretty reliable.

 

[dr zaius]

Sometimes patients are so obese that it's difficult to even hear heart sounds on auscultation much less feel them.

 

[SpecterGT260]

Sometimes patients are so obese that it's difficult to even hear heart sounds on auscultation much less feel them.

It doesnt even take much before the PMI is damn near impossible to find. Women are even more difficult to find it on.

 

[gasblaster]

Because you can have a contracting heart without having a pulse.

But you can't have a pulse without an adequately contracting heart.

In general.

 

[SpecterGT260]

Because you can have a contracting heart without having a pulse.

But you can't have a pulse without an adequately contracting heart.

In general.

👍

OP: That's another good point I didnt think of. Pulse isnt always just about determining HR. It is simultaneously assessing the vascular system. In the complete physical exam you will take the pulse in about 10 different places.

 

[donkeykong1]

Because you can have a contracting heart without having a pulse.

But you can't have a pulse without an adequately contracting heart.

In general.

this is the answer

Example: the best way to confirm a murmur as systolic is to feel the pulse while auscultating. If the murmur is heard in time with the pulse, it is generally systolic.

 

[SpecterGT260]

this is the answer

Example: the best way to confirm a murmur as systolic is to feel the pulse while auscultating. If the murmur is heard in time with the pulse, it is generally systolic.

That isnt what he was saying there. You can have heart contraction in a manner that does not effectively pump. You would feel it on the chest just fine (if the person was thin enough). Auscultation is a whole other thing. You are correct, though, that feeling the radial pulse can tell you which beat a murmur is on if you have difficulty just by listening.

 

[donkeykong1]

That isnt what he was saying there. You can have heart contraction in a manner that does not effectively pump. You would feel it on the chest just fine (if the person was thin enough). Auscultation is a whole other thing. You are correct, though, that feeling the radial pulse can tell you which beat a murmur is on if you have difficulty just by listening.

no argument there. the murmur statement was just an example about the utility of an arteriole pulse.

 

[image187]

please google: pulsus alternans, waterhammer pulses, pulsus tarde et parvus, pulse deficit, and a number of other important clues you can gather in feeling ones peripheral pulses. The pulse is not equal to the heart rate, it is a multidimensional component of the physical exam that can give a lot of insight to the current state of the cardiovascular system.

 

[calvnandhobbs68]

Oh sorry, I mostly meant outside the clinic (should have been more clear).

Every runner I've seen stops and checks via radial or carotid.

In this scenario it's just because it's a lot easier than slapping your hand on your chest. Radial pulses are extremely easy to feel if you want to take a quick pulse on yourself anytime during the day. It's also easy to access...you typically aren't wearing layers of clothing over your wrists.

 

[SpecterGT260]

In this scenario it's just because it's a lot easier than slapping your hand on your chest. Radial pulses are extremely easy to feel if you want to take a quick pulse on yourself anytime during the day. It's also easy to access...you typically aren't wearing layers of clothing over your wrists.

Or fat or muscle

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[Shinken]

Plus, a runner that stops and puts his hand on his chest is just asking for the event paramedics to stop what they're doing and run towards him with a stretcher.

 

[45408]

Your radial artery pulse is superficial, easily palpable, not a "sensitive" area, and almost always corresponds with your heart rate. If the heart rate gets too high or erratic, a peripheral pulse is unreliable, but that's not really what we're talking about.

 

[link2swim06]

Your radial artery pulse is superficial, easily palpable, not a "sensitive" area, and almost always corresponds with your heart rate. If the heart rate gets too high or erratic, a peripheral pulse is unreliable, but that's not really what we're talking about.

👍 Had this happen to me on internal medicine with a pt with a fib.

 

[45408]

👍 Had this happen to me on internal medicine with a pt with a fib.

The opposite can fool you too. I got called for "new onset a-fib" on a floor patient. I got up there, checked her pulse, which was as regular as can be, rate of 70 or so. The nurse insisted that it was irregular when she listened. I listened to her heart and recognized that she had very loud physiologic S2 splitting. It took several respirations before I realized what it was, and it did sound like a-fib usually does.

 

[Instatewaiter]

this is the answer

Example: the best way to confirm a murmur as systolic is to feel the pulse while auscultating. If the murmur is heard in time with the pulse, it is generally systolic.

Be careful. This is not always reliable.

For instance in critical AS, the murmur will become soft, it will obscure S2 and the peripheral pulses will be late.

 

[MSHell]

When I measure my heart rate, I just put my hand to my chest and take it that way. I was wondering why we have these roundabout ways (arteriole pulses) to measure the HR.

My heart beat is also stronger than my arteriole pulse. So, it's even easier in that sense.

please google (or read up on) arteriole vs. arterial.
kthxbai

 

[SpecterGT260]

please google (or read up on) arteriole vs. arterial.
kthxbai

U just mad u don't have my skillz to read capillary pulses.

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[Geebeejay]

U just mad u don't have my skillz to read capillary pulses.

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Dont worry, he'll get there eventually. 🙂

Radial pulse is probably easier to feel than your heart contracting when you have a high pulse (i.e. after cardio). I actually like to feel my carotid during exercise, but if your radial pulse is unpalpable during exercise, you may wanna tune it down a notch or hydrate better.