Pulses In The Body

Pulses In The Body Diagram
Pulses In The Body Rate Chart
Pulses In The Body Rate

You need to understand a few things. First, this has to do with nerves. Though infections are possible, that is not the angle to worry about. You need to give up alcohol and smoking AND medications. The latter is of course your call as you might w.
The pulse is a palpable pressure wave in response to contractions of the heart (systole). As blood is forcefully pushed out of the heart, the elastic artery walls distend to accommodate the blood and rebounds to keep the blood flowing at pressure.
Radial pulse: MedlinePlus Medical Encyclopedia Image Arteries carry oxygenated blood away from the heart to the tissues of the body. Veins carry blood depleted of oxygen from the same tissues back to the heart. The arteries are the vessels with the pulse.

Written by: Jim Folk.
Medically reviewed by: Marilyn Folk, BScN.
Last updated: February 9, 2021

The pulse rate is a measurement of the heart rate, or the number of times the heart beats per minute. As the heart pushes blood through the arteries, the arteries expand and contract with the flow of the blood. Taking a pulse not only measures the heart rate, but also can indicate the following. Also known as black chana or garbanzo beans, Bengal gram is a staple ingredient in.

Pulsing or throbbing muscles, Pulsing or throbbing sensation descriptions:

You may feel a pulsing sensation in one or more muscles or groups of muscles, or parts of the body.
This pulsing throbbing feeling can be a slow, mild, rhythmic pulsing or throbbing, or may feel like a rapid gentle tremor-like sensation, or a combination of these sensations.
This pulsing throbbing feeling may be visible to the eye, or not visible at all.

This pulsing throbbing feeling can persistently affect one area only, can shift and affect another area or areas, and can migrate all over and affect many areas over and over again. Omnifocus 2 for mac pro.

This pulsing throbbing feeling can come and go rarely, occur frequently, or persist indefinitely. For example, you may feel a pulsing throbbing feeling once in a while and not that often, feel it off and on, or feel it all the time.

This pulsing throbbing feeling may precede, accompany, or follow an escalation of other anxiety sensations and symptoms, or occur by itself.

This pulsing throbbing feeling can precede, accompany, or follow an episode of nervousness, anxiety, fear, and elevated stress, or occur ‘out of the blue’ and for no apparent reason.

This pulsing throbbing feeling can range in intensity from slight, to moderate, to severe. It can also come in waves, where it’s strong one moment and eases off the next.

This pulsing throbbing feeling can change from day to day, and/or from moment to moment.

All of the above combinations and variations are common.

This pulsing throbbing sensation can be more noticeable when resting, relaxing, or when trying to go to sleep.

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What causes the anxiety symptom pulsing throbbing sensation?

Anxiety causes the body to produce the stress response (also known as the fight or flight response). The stress response adversely affects the body's nervous system, which is responsible for the nerve impulses that cause muscle movements. When the nervous system becomes overly stressed, it can act in erratic and more involuntary ways. Experiencing pulsing throbbing muscles and/or muscle groups is an example of this erratic and more involuntary behavior.

How to get rid of the anxiety symptom?

Because this symptom is just a symptom of elevated stress, it needn't be a cause for concern. It's not dangerous and is generally not an indication of something more serious. This pulsing throbbing sensation will subside when you reduce your body's stress and give your body ample time to calm down. As your body's stress returns to a normal level, symptoms of stress subside, including the pulsing throbbing anxiety symptom. Therefore, this anxiety symptom needn't be a cause for concern.

For a more detailed explanation about all anxiety symptoms, why symptoms can persist long after the stress response has ended, common barriers to recovery and symptom elimination, and more recovery strategies and tips, we have many chapters that address this information in the Recovery Support area of our website.

The combination of good self-help information and working with an experienced anxiety disorder therapist is the most effective way to address anxiety disorder and its many symptoms. Until the core causes of anxiety are addressed - the underlying factors that motivate apprehensive behavior - a struggle with anxiety disorder can return again and again. Identifying and successfully addressing anxiety's underlying factors is the best way to overcome problematic anxiety.

Additional Resources:

For a comprehensive list of Anxiety Disorders Symptoms Signs, Types, Causes, Diagnosis, and Treatment.
Anxiety and panic attacks symptoms can be powerful experiences. Find out what they are and how to stop them.
Free online anxiety tests to screen for anxiety. Two minute tests with instant results. Such as:
Anxiety 101 is a summarized description of anxiety, anxiety disorder, and how to overcome it.

Return to Anxiety Disorders Symptoms section.

anxietycentre.com: Information, support, and therapy for anxiety disorder and its symptoms, including the anxiety symptom pulsing throbbing.

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Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European Guidelines. You may find one of our health articles more useful.

Treatment of almost all medical conditions has been affected by the COVID-19 pandemic. NICE has issued rapid update guidelines in relation to many of these. This guidance is changing frequently. Please visit https://www.nice.org.uk/covid-19 to see if there is temporary guidance issued by NICE in relation to the management of this condition, which may vary from the information given below.

Pulse Examination

It is very easy to overlook the art of clinical examination when new technology can so easily be employed to make diagnoses. Systematic cardiovascular examination can provide a diagnosis quickly without need for invasive or expensive tests. Such routine examination can reveal an unexpected and timely diagnosis.

History

As with all clinical examination, there are aspects of the history which are particularly relevant to abnormalities in the pulse. There are many symptoms which may be relevant; however, some examples include:

Cardiovascular symptoms including:
- Chest pain (at rest or on exertion).
- Palpitations.
- Syncope.
- Claudication.
- Tiredness or lethargy.
- Shortness of breath on exertion.
Age (affects the likelihood of atherosclerosis).
Past medical history (particularly of thyroid, cardiovascular and cerebrovascular disease).
Lifestyle and occupation (the fit and trained athletes have very low pulse rates).
Medication (many drugs can affect the pulse, including beta-blockers and digoxin).

Examination

General inspection

Observe the patient whilst taking the history. Look for:

Apprehension or anxiety.
Breathlessness.
Cyanosis.
Pallor or anaemia.
Features of specific diseases, especially those associated with cardiovascular disease:
- Thyroid disease.
- Recognisable syndromes.
Pulsations in the neck:
- Arterial and venous pulsations (jugular venous pulse) may be visible in the neck.
Head movement:
- de Musset's sign (the head nods in time with the heartbeat - seen rarely in severe aortic regurgitation).
Take the patient's hand and assess:
- Warmth (fever, thyrotoxicosis).
- Sweating.
- Tremor.
- Nails:
  - There may be peripheral cyanosis.
  - Clubbing of the nails (may indicate other disease, although clubbing can be congenital and benign).
  - Splinter haemorrhages (infective endocarditis).
  - Koilonychia (might indicate iron deficiency).
  - Quincke's sign is pulsation of the capillary nail bed (with the very wide pulse pressure of aortic regurgitation).

Examining the pulse

Arterial pulses can be examined at various sites around the body. Systematic examination normally involves palpating in turn radial, brachial, carotid, femoral and other distal pulses. Palpation of the abdominal aorta would also form part of this systematic examination (to identify abdominal aortic aneurysms for example). Other sites may be examined for pulses, in special circumstances - for example, the temporal artery (for tenderness in temporal arteritis) and the ulnar artery (if the radial cannot be felt or before arterial access at the radial site).

Which pulse should be examined?

This will depend on circumstances and whether there are specific clinical reasons for examining a particular pulse or for systematically examining all arterial pulses.
In clinical examinations it is important that the student follow instructions and take clues from the questions posed by the examiner and the type of examination (distinguish, for example, between a request to examine a pulse and conducting a cardiovascular examination). Such examination technique can be practised according to the requirements of the particular examination to ensure success.
Clinically it is traditional to examine the radial pulse first. However, there is much to commend routinely following this with examination of the larger brachial and carotid arteries to feel the nature of the wall and particularly the character of the pulse.
There are, of course, specific reasons to examine all the pulses at different sites as part of a complete and systematic cardiovascular examination. As ever, in clinical practice there will be some selectivity to save time in the consultation.

Press back to feel carotid artery against precervical muscles.

Alternatively from behind, curling fingers around side of neck.

Do not press too hard for fear of obliterating the pulse.

Establish whether the wall feels soft and pliable or hard and sclerotic.

Identify the qualities or characteristics of the pulse by asking:

What is the pulse rate?
What is the pulse rhythm?
What is the character of the pulse?

What is the pulse rate?

A normal pulse rate after a period of rest is between 60 and 80 beats per minute (bpm). It is faster in children. However, if tachycardia is defined as a pulse rate in excess of 100 bpm and bradycardia is less than 60 bpm then between 60 and 100 bpm must be seen as normal.
An irregular pulse or a slow pulse should be measured over a longer time. As a guide, it is unwise to measure a regular rate for less than 20 seconds (30 seconds being preferable) and an irregular pulse should not be measured over less than 30 seconds, preferably a full minute.
Bradycardia may be physiological in a trained athlete, even if training was many years ago.
Paroxysmal tachycardia can last a few minutes to several hours. It might be too transient to allow an ECG recording during an attack so that only clinical examination is available.
Paroxysmal atrial fibrillation (AF) or, more rarely, atrial flutter, produces a ventricular rate that is dependent upon the refractory time of the A-V node.
Re-entry tachycardia such as Wolff-Parkinson-White syndrome can produce a very fast rate in the region of 200 bpm.
As a general rule, supraventricular tachycardia (SVT) produces a rate above 160 bpm and ventricular tachycardia (VT) below 160 bpm.
Even in young people, very fast rates of 200 bpm or more can precipitate heart failure.

What is the pulse rhythm?

Sinus arrhythmia occurs when there is variation of rate with breathing. It accelerates a little on inspiration and slows a little on expiration. This can be quite marked in children and adolescents but is uncommon over the age of 30. It can persist a little longer in the physically fit.
Pulsus paradoxus:

The pulse slows on inspiration in pulsus paradoxus and it can occur with pericardial effusion, constrictive pericarditis and severe pneumothorax, especially tension pneumothorax, severe asthma and severe chronic obstructive pulmonary disease (COPD).^[1]
In normal circumstances, the systolic blood pressure often falls slightly, by less than 10 mm Hg on inspiration; however, in pulsus paradoxus it falls by more than this.^[2]This fall can be used to assess the severity of cardiac tamponade.

Irregularity is more difficult to discern if the rate is fast.
Note if it is regularly irregular of irregularly irregular:
- Variable heart block or premature ventricular excitation will cause either an extra beat or a missed one. Premature ventricular contraction may cause a missed beat because the ventricle has not had time to fill adequately and so the stroke volume is low. The beat following a missed beat, whether due to premature excitation or failure of the ventricle to beat, may be rather stronger than the others, as the ventricle has filled more in the longer diastole. This irregularity will follow a regular pattern.
- A much more random irregularity is a feature of AF. If the rate is fast in AF, it may be difficult to note if the irregularity is random or even if there is irregularity at all. It may be helpful to measure the rate at both the cardiac apex and the wrist and in AF there is usually a deficit at the radial pulse. This is usually done with two people timing simultaneously but it can be done alone, not timing but merely noting if the rates differ. The rate in AF and the rarer atrial flutter depends upon the degree of A-V block but it can be very fast.
- It has been suggested that a way to distinguish between causes of irregularity is to get the patient to exercise to increase the pulse rate. In premature ventricular excitation it will reduce or disappear. In AF it will increase the irregularity or at least not reduce it.
- Currently, most clinicians would use the ECG for a more reliable means of distinction.

What is the character of the pulse?

Finally, note the character of the pulse. This incorporates an assessment of the pulse volume (the movement imparted to the finger by the pulse) and what has been described as the 'form of the pulse wave'. The pulse character must be interpreted in the light of pulse rate.

Cardiac output is the product of stroke volume and heart rate. Thus, a slow pulse may be associated with a high stroke volume and, as there is a long time between each ejection, the pulse pressure (the difference between systolic and diastolic pressure) will be high.
In shock, the pulse will be fast but weak. This might be from hypovolaemia or cardiogenic. In congestive heart failure one of the first features is tachycardia.
A hyperdynamic circulation occurs in emotion, heat, exercise, anxiety, pregnancy, fever, anaemia and thyrotoxicosis. The pulse rate is raised but the pulse is full and bounding. Cardiac output is high and peripheral resistance is low.
Disease of the aortic valve will affect the nature of the pulse wave:
- In aortic stenosis, the wave is slow to rise and the pattern of the arterial pressure is rather flat - the slow rising pulse.
- In aortic regurgitation, the stroke volume is high because a significant amount of blood sinks back into the ventricle and has to be pumped again. Furthermore, the incompetent valve will let the arterial pressure fall markedly in diastole. Hence, a bounding, dynamic pulse collapses to give a very wide pulse pressure. This is called a collapsing or water hammer pulse. The water hammer is a piece of Victorian engineering that is rarely seen these days. The collapse of the pulse pressure can be felt with even greater effect if the patient's hand is raised over his or her head so that the radial artery is palpated at a level rather above the heart. Severe aortic regurgitation, classical of syphilitic aortitis, can cause the head to jerk with each pulse (de Musset's sign).
- In mild aortic stenosis with reflux, the pulse detected may have two peaks as well as being slow rising. This is the so called bisferiens pulse.

Studies have correlated markers of arterial stiffness (eg, pulse-wave velocity and pulse pressure) with risk for the development of fatal and non-fatal cardiovascular events.^{[3, 4]}

The next step

This systematic examination of the pulse will give a great deal of information. Examination of the rest of the cardiovascular system should give a very clear idea of the diagnosis or at least put the examiner in a position to make a rational request for further investigations. Systematic examination of the pulse remains an essential part of clinical practice.

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Khasnis A, Lokhandwala Y; Clinical signs in medicine: pulsus paradoxus. J Postgrad Med 200248:46-9
Hamzaoui O, Monnet X, Teboul JL; Pulsus paradoxus. Eur Respir J. 2013 Dec42(6):1696-705. doi: 10.1183/09031936.00138912. Epub 2012 Dec 6.
Liao J, Farmer J; Arterial stiffness as a risk factor for coronary artery disease. Curr Atheroscler Rep. 2014 Feb16(2):387. doi: 10.1007/s11883-013-0387-8.
Boutouyrie P, Fliser D, Goldsmith D, et al; Assessment of arterial stiffness for clinical and epidemiological studies: methodological considerations for validation and entry into the European Renal and Cardiovascular Medicine registry. Nephrol Dial Transplant. 2014 Feb29(2):232-9. doi: 10.1093/ndt/gft309. Epub 2013 Sep 30.