Evaluation of pulse

Definition:

The clinical use of palpation to obtain a qualitative and quantitative reading of an individual’s pulse.

Test procedure:

The exact procedure will vary according to the site at which an individual’s pulse is being taken. There are however, certain principles common to all evaluation sites:

  • the use of palpation to locate the artery to be assessed
  • the recording of the number of pulsations per minute
  • the patient being at rest and free of any stimulants when examined
  • the screening of the pulse for any pathological signs

Test findings:

Pulse patterns:

    1. Pulsus bisferiens: uncommon finding typically associated with patients suffering from aortic valve diseases. The practitioner will note two pulses per heart beat as opposed to the normal one beat.
    2. Pulsus alternans: indicative of progressive systolic heart failure. The practitioner will note a strong pulse pursued subsequently by a weak pulse.
    3. Pulsus paradoxus: associated with an excessive decrease in blood pressure during the inhalatory phase of respiration. A diagnostic sign of respiratory and cardiac conditions. The practitioner notes that some heartbeats cannot be detected at the radial artery during inspiration.
    4. Pulsus bigeminus: the detection of hoof beats and potential gallop rhythm during auscultation. Gallop rhythms may be heard benignly in young athletes but may also be indicative of heart failure and pulmonary oedema especially in adults.
    5. Pulsus tardus et parvus: indicative of a loss in compliance in the aortic valve. The practitioner notes a slower (compared to normal) rise in the tactile pulse.
    6. Tachycardia is the term used to describe an abnormally elevated resting pulse rate.

    An individual’s pulse is also categorised according to its strength:

    0 – absent
    1 – hardly palpable
    2 – easily palpable
    3 – full
    4 – aneurysmal or bounding pulse.

    Special considerations:

    The quality and quantity of pulses will only give the practitioner so much information pertaining to an individual’s health and often only offers a rough guide. Further investigations such as ElectroCardioGrams (ECG) are often necessary.