PULSE

We view it as the symbol of life itself and in fact the pulse gives doctors valuable information about the condition of the heart and major arteries of the body

When a doctor feels the pulse, he is feeling the action of the heart pumping blood with each beat around the body by means of the arteries.

The force of each heartbeat is transmitted along the arterial walls just as a wave travels across the surface of a lake. The walls of the arteries are elastic and expand to take the initial force of a heartbeat. Later in the course of the beat they contract and in this way push blood smoothly along the system.

THE BODY'S PULSE

The pulse can be felt in a number of the arteries that lie near the surface of the body. The most common is the radial artery in the wrist which can be felt on the inner surface of the wrist just below the thumb. It is customary to feel this pulse with one or two fingers rather than the thumb, which has its own pulse and can therefore cause some confusion.

The brachial artery in the arm has a pulse can likewise be easily felt on the inside of the elbow joint almost in line with the little finger.

A doctor may also examine the pulse in the neck created by the carotid artery. This pulse is located about 2.5 cm (1 in) below the angle of the jaw. He may listen to a major artery like the carotid with a stethoscope which can revel a ‘bruit’ a regular whooshing noise with each heart beat. This may indicate a partial blockage of the artery even though the pulse feels quite normal.

There are also pulses in the groin, behind the knees, on the inside of the ankle and on tope of the foot.

WHAT IS LEARNT FROM THE PULSE ?

The first thing a doctor discovers is simply the condition of the arteries themselves. This can be decided on the basis of whether all the pulses are present and normal. It is particularly important to see if the pulses in the legs are present, since the arteries in the legs are most liable to arteriosclerosis (furring up of the arteries). If these pulses are diminished or difficult to feel, arteriosclerosis may have already developed.

A doctor also used the pulses to gauge the working of the heart. A regular rhythm suggests that the heart is beating regularly, since the pulse rate gives an exact indication of the heartbeat. Some times there can be a discrepancy between the heart rate and the pulse because some of the beats the heart is making are too weak to be transmitted along the arterial system. This suggests heart trouble.

A fast heartbeat (tachycardia), of more than 120 beats per minutes, occurs as a normal response on exertion, or as the result of a fever. It may also be caused by an abnormality in the heart’s electrical conducting system.

A slow heart beat may be normal, particularly in athletes, but rates of less than 50 beats per minute are abnormal, especially in the elderly. This can mean that there is a heart block due to an interruption of the conduction of electrical impulses in the heart. It can also be caused by over activity of the parasympathetic part of the autonomic nervous system. This creates the drop in heart rate that leads to a faint.

Even unusual diseases may be pointed by an examination of the pulses. When the pulses in the legs are diminished in force and delayed in time compared with those in the arms, a rare congenital problem may be indicated. In this, the body’s main artery, the aorta, is blocked as it passes down the chest.

The pulses in the legs, and even in one or both of the arms, may disappear in a commoner disease known as dissection of the aorta, where the inner lining of the aorta is torn. This forces blood into the arterial wall, again creating a blockage.

The shape of a pulse wave may also help a doctor in diagnosis. For example, a slowly rising pulse indicates obstruction of the aortic valve, while a pulse which rises fast and falls away again - indicates a leaking aortic valve. Both cases may require surgery.