Is heart rate the same as pulse?

Measurement of heart rate or pulse rate are used for diagnosis or monitoring of medical condition. These are the most common parameters used in patient management. Although the answer to the article’s question is yes, it is interesting to learn how all this works in our body. To understand this, some basic information about anatomy and physiology of  cardiovascular system is required. 

Cardiac cycle

Heart is a muscular pump which contracts rhythmically to pump blood into all parts of our body. It is controlled by autonomic nervous system. The sequence of contraction and relaxation of heart is called cardiac cycle. When the heart contracts (called systole), blood is pumped out into the systemic circulation which supplies all organ systems and tissues. During relaxation of heart (called diastole), venous blood returns to the heart. This sequence of cardiac cycle produces heart beats. Normal frequency of heart beats or heart rate is 60 to 100 per minute. This range allows for variation depending on age, fitness status, exercise and sleep. Physically fit people may have a resting heart rate as low as 45. The lower the heart rate the more efficiently the heart is working. This indicates better cardiovascular reserve.

Pulse rate

Cardiac cycle pushes blood through arteries in a pulsatile fashion. This is palpated in arteries which are elastic and can expand or contract depending on the flow of blood during systole and diastole respectively. Hence the heart rate is reflected in the form of pulse rate and it is same. In clinical practice, pulse characteristics like rate, rhythm and volume are used for assessment of hart functions. Pulse is normally felt in the radial artery at the wrist. In cases of low blood pressure, the carotid artery in the neck is palpated to assess the heart rate.

The other sites where the pulse rate can be checked include ulnar artery at the wrist, brachial artery at the elbow, femoral artery at the groin, posterior tibial artery on the inner side of ankle behind the malleolus, dorsalis pedis artery over dorsum or upper surface of foot, popliteal artery behind the knee, aorta over upper abdomen, superficial temporal artery over temple and facial artery over edge of lower jaw.

Abnormal rate

When there is an abnormality in the rhythm of cardiac contraction, as seen in cardiac arrhythmias, it is again reflected in alterations in the rhythm of pulse. The pulse becomes irregular in rhythm and volume. In certain abnormal rhythm patterns of heart the ECG may show a different rate when compared to the pulse rate. This occurs in special situations and requires an assessment by a cardiologist.

Tachycardia 

When the heart rate is above the normal range it is called tachycardia. It is seen in conditions like exercise, stress, pregnancy which is physiological. In conditions like fever, anemia, hyperthyroidism, cardiomyopathy, sepsis and shock, it is pathological and reflects the disease severity.

Bradycardia

In case of  bradycardia the heart rate is less than normal. This may depend on age – children have a higher rate than adults and other physiological factors. Also athletes have a lower range of normal heart rate. Pathological bradycardia is seen in hypothyroidism, late stage of shock, heart block and syncope.

A lot of gadgets and cell phone apps are now available which can be used to monitor heart rate or pulse rate during exercise. Though there is a lot of online information one should consult a doctor if the heart / pulse rate is outside the normal range or is beating irregularly.