Causes of different pulses in the hands. Different blood pressure in the arms: reasons

Article publication date: December 31, 2016

Article updated date: 12/18/2018

From this article you will learn: what causes different pressure on hands; when it's normal and when it's not. Why is it necessary to measure blood pressure on both hands?

Many people who measure and monitor blood pressure do not do the right thing if they perform tonometry on only one arm. But even those who do this from both sides, noticing the difference in numbers, cannot correctly assess the significance of such a phenomenon.

Rules for measuring pressure on both hands

The pressure difference between the left and right hand maybe absolutely normal occurrence, and evidence of disease. According to some literature data, about 50% of patients with a pronounced difference in indicators (more than 20 mm Hg) die within 10 years. Having learned about this, many people for whom this condition may be a variant of the norm begin to panic and independently treat a non-existent disease, although in fact there is no need to do anything - after all, they are healthy. A 15–20% difference in pressure on the hands is really alarm signal diseases requiring immediate clarification of the cause and special treatment.

A specialist - a therapist or family doctor. If necessary and depending on the suspected cause, they will prescribe a consultation with other specialists: a cardiologist, vascular surgeon, neurologist. Correct diagnosis and treatment not only normalize blood pressure, but also prevent more serious threats . It is possible to be cured.

How to figure out whether this is normal or pathological

If, after measuring the pressure of yourself, your loved ones, or any other people, you notice a difference in numbers between your right and left hands, pay attention to several facts that are described and deciphered in the table:

What to look for	Features of the influence of the factor on pressure
The magnitude of the difference (by how many mmHg do the indicators differ)	The permissible range of fluctuations is 5–10 mm Hg. Art. both upward and downward. How more difference, the more it speaks of pathology.
On which arm is blood pressure changed?	In both normal and pathological conditions, pressure asymmetry is recorded equally often on both the right and left
Increased or decreased blood pressure	If it is normal or high on one hand, and even higher on the other, the problem is less dangerous than a decrease in numbers below normal on one side against the background of normal ones on the other.
Age	In teenagers and older people age group blood pressure difference occurs more often
Right-handed or left-handed	The pressure increases mainly on the main working hand
Is the person connected with active sports and physical work	If so, it is more likely that the BP asymmetry is a result of them
Presence of complaints and symptoms	If they exist, this indicates pathological nature pressure asymmetry

If you measure your blood pressure rarely, but because of some complaints or out of curiosity, be sure to do it on both hands. If you perform tonometry daily, then measure the indicators on the right and left at least once a month.

Who can be calm and why?

From the table above, we can conclude that a discrepancy in blood pressure between the right and left arms is always a variant of the norm, only if the difference in indicators does not exceed 5–10 mm Hg. Art. (it is typical for 50–60% of people). In all other cases, the interpretation of data must be approached individually.

On which hand should the pressure be higher normally?

Pressure asymmetry in the form of a unilateral increase is less dangerous than a unilateral decrease if the numbers on the second arm are normal or elevated (from 100/60 to 140/90 and above).

Increased pressure may be on the left arm

In healthy, right-handed young people who are not involved in intense physical activity, the pressure on the left hand may be higher than on the right. In actively working left-handers, this difference may be even greater (about 20 mm Hg).

Explanation: main artery, the blood supply to the arm - the subclavian - on the left departs directly from the aorta, so the blood pressure in it is higher. The right moves away from less large vessel– brachiocephalic trunk, so the pressure in it is lower.

Increased pressure may be on the right arm

In right-handed people associated with active physical activity, the indicators on the right should be higher than on the left, but within the acceptable numbers. Explanation: against the background of systematic loads, the muscles of the shoulder and shoulder girdle, through which the subclavian and brachial arteries pass, increase in volume and become dense. This causes mechanical compression of the vessels, due to which the pressure in them increases.

Who should be wary

Suspect that the blood pressure is different different hands- this is a symptom of pathology, it is possible in cases where the indicators differ by more than 10–20 units. The greater this difference, the more serious problem. Possible situations and the reasons are described in the table.

Most frequent illnesses, in which the patency of the arteries of the upper extremities is impaired:

Atherosclerosis – cholesterol plaques.
Thrombosis and thromboembolism - the formation of blood clots on the walls or their entry from the heart.
Aortoarteritis is inflammation of the vascular wall.
An aneurysm is a sac-like expansion and destruction of the arterial wall.
Scalenus syndrome is a thickening of the muscle fibers through which the subclavian artery passes.
Tumors of soft tissue and bones in the area chest and shoulder.
Injuries and operations on blood vessels.

Possible manifestations

Due to the fact that a strong decrease in pressure in one arm indicates blockage of the arteries and impaired circulation in it, the following symptoms arise:

The brush loses strength.
Fingers become cold, pale and numb.
There may be cyanosis of the fingertips or the entire hand.

But if the pressure decreases on the right hand, in addition to these symptoms, signs of cerebrovascular accident occur. This is due to the fact that the vessels supplying half of the brain and the upper limb originate from the aorta on this side common trunk. These are the signs:

headache;
dizziness;
protracted speech;
memory loss;
paralysis of half the body;
facial distortion.

Symptoms of impaired blood supply to the brain and arm

Conclusion: the true pressure in a person with different indicators on the left and right hand is the one that is higher. Therefore, if you want to evaluate the current hypertension and treatment effectiveness antihypertensive drugs, focus only on him.

Who needs treatment

If the pressure difference between the left and right hand does not exceed 10 mmHg. st – no treatment is required at all. If this difference increases by more than 15–20 points, you need to contact a specialist. This could be a family doctor or internist. You may need specialized treatment under the supervision of a vascular surgeon, neurologist, cardiologist.

This may require:

Regular tonometry (measurement of indicators).
Taking medications that restore vascular patency, slow the progression of atherosclerosis or aortoarteritis, thin the blood and improve blood circulation.
Drug treatment of hypertension and vegetative-vascular dystonia.
Gymnastics and physiotherapy for the belt upper limb and physiotherapeutic procedures for this area.
Surgical treatment – removal of blood clots, cholesterol plaques, placing stents and even replacing damaged arteries with an artificial prosthesis.

Treatment for pressure differences between the right and left hands

If you seek help immediately after detecting such a deviation, treatment will help eliminate not only the pressure deviation, but also its cause. Targeted treatment completely solves the problem - you can be cured.

Forecast

If the difference in pressure on different hands is acceptable, there is nothing to be afraid of - there are no threats.

If, simultaneously with the disruption of the blood supply to the hand, the cerebral circulation– against this background, a stroke often occurs, and with widespread atherosclerosis coronary vessels a heart attack may also occur. This is why a pronounced pressure difference across the arms often precedes these dangerous diseases, which in 50% of cases end in the death of patients.

Many devices can measure heart rate. But how accurate are their readings?

What is pulse?

Some people mistakenly believe that heart rate and heart rate are the same thing, which is a misconception. What's the difference?

Heart rate is an indicator characterizing the number of contractions of the ventricles of the heart in one minute. That is, it reflects the following: how many times within a minute the ventricles filled with blood and then pushed it into main arteries(aorta and pulmonary artery).

If a person is healthy, then the number of heart contractions per minute should coincide with the number of pulse waves felt. But for a number of diseases and pathological conditions, these indicators may differ. In a healthy adult, the heart rate ranges from 60 to 90 pulses per minute. In children, this indicator depends on age. How younger child, the higher his pulse rate.

A person's heart rate is not constant. The pulse changes during sleep and wakefulness, during physical activity and rest, during sports, after meals and some. Heart rate depends on mood, body position, temperature environment and some other factors. Females have a faster pulse than males. People who exercise intensively have a slower pulse.

Why does a person measure his pulse?

The human pulse has six characteristics: frequency, filling, tension, rhythm, height and shape. These properties are studied by the doctor during the examination of the patient. Self-measurement of the pulse among ordinary people usually has only one goal: to find out its frequency.

At what pathological conditions does your heart rate increase?

For diseases of an infectious nature;
For congenital and acquired heart defects;
In case of cerebrovascular accident;
For a number of diseases endocrine organs, nervous system;
With a decrease in hemoglobin and red blood cells in the bloodstream (anemia);
For some tumor processes and etc.
When does your heart rate drop?
When taking certain medications;
For athletes and those engaged in heavy physical labor.
For poisoning, stomach ulcers;
With decreased thyroid function (hypothyroidism);
With inflammation of the heart muscle;
For myocardial infarction, etc.

In these conditions, a person does not measure his own pulse, and this is not required. More often, athletes who control the intensity of their training and people suffering from heart and vascular diseases regularly measure their pulse. Based on the pulse rate, they can draw conclusions about their condition on this moment and notice problems in time. Next, we will discuss how to correctly measure your pulse and what devices will make this task easier.

How to measure your pulse correctly without the help of special devices?

Pulse measurement is carried out in different situations: at rest, during exercise, after exercise; and also in different positions of the subject: standing, lying, sitting. It all depends on the purpose of the research. But regardless of the reason why the pulse is measured, the technique for such research is the same.

Anyone can learn to measure their pulse on their own. There's nothing complicated about it. The pulse is measured in those arteries that are located close to the surface of the body: brachial, radial, carotid, femoral, etc. Most often, the pulse is measured in radial artery, that is, on the wrist. To be more specific, in the area of the wrist joint.

How to measure the pulse on your own hand?

Normally, the pulse can be felt equally on the right and left hands. The radial artery passes from the inner (palm) side of the wrist from its lateral edge, that is, along the side where the thumb is located. There is no need to try to feel the pulse from the side of the little finger - nothing will work. The wrist of the hand on which the pulse will be measured should be kept at heart level.

In order to correctly measure the pulse in your hand, you need to place the wrist of one hand (for example, the left one) with the back of your hand on the palm of your hand (in our example, the right one). Then you need to grab the wrist of your left hand with the fingers of your right hand so that the fingertips are located closer to the lateral side of the wrist (from the side thumb left hand). At the same time, the pad index finger the right hand is closest to the wrist joint.

Under the fingertips there will be just the radial artery, on which the pulse waves will be felt. After this, you should press slightly with your fingertips on your wrist in a downward direction and towards radius(passes from the side of the thumb).

How does your pulse feel? Under the pads of the fingers (especially the index and middle fingers), an oscillation of the arterial wall (pulse wave) will be felt, occurring with a certain periodicity. Within a minute, it is worth calculating how many pulse waves will be felt. It is also quite easy to evaluate another property of the pulse - its rhythm. Normally, the time intervals between pulse waves should be the same.

If the pulse is rhythmic, then in some situations, for speed, you can measure the pulse for 30 or 20 seconds, and then multiply the result by 2 or 3, respectively, to find out the pulse rate per minute. But according to the rules, you should count your pulse exactly per minute.

How to measure the pulse on another person's hand?

Another person's technique for measuring pulse is exactly the same. The person taking the measurement wraps his hands around the subject’s wrists. It is important that the pads of his index and middle fingers are in the projection of the radial artery of the subject. The examiner then counts the number of pulse waves per minute. The convenience of measuring the pulse of another person is that you can evaluate and compare the pulse on both hands at once. The technique for measuring a child's pulse is similar.

A tonometer is the most popular medical device.

Medical devices for measuring pulse at home

Are there medical devices that can be used to measure your pulse at home? Yes, these include automatic and semi-automatic blood pressure monitors, as well as a pulse oximeter. Now we will talk about them in more detail.

One of the differences between automatic and semi-automatic blood pressure monitors and a pulse oximeter is that they can also be used to determine blood pressure. This made them popular in all Russian families. Depending on the type of cuff included with the device, measurements are taken on the brachial or radial artery.

To correctly measure pulse and blood pressure, the patient needs to calm down and take a seat. comfortable position, for example, sit down. Then put the cuff of the device on your shoulder or wrist (according to the instructions and packaging), place your hand in such a position that the cuff is at heart level. Further actions vary slightly depending on the type of device.

When working with a semi-automatic device, you must inflate the cuff yourself using a rubber bulb. The automatic device will inflate the cuff itself through the operation of the compressor after pressing the desired button on the tonometer. After the cuff is inflated, the device will begin measuring blood pressure and pulse, and the results of this study will be reflected on the device display.

To learn the nuances of the procedure and avoid mistakes, you should carefully read the instructions for the device even before you begin working with it. The convenience of such tonometers is that a certain number of recent measurements remain in the device’s memory.

Before buying a tonometer, you should consult with your doctor which device is better. For example, if you plan to measure blood pressure and pulse for children, then you need to purchase a model with children's cuffs different sizes. It is worth noting the fact that the main task of a tonometer is to measure blood pressure, and it is for this procedure that such a device is purchased, and pulse counting can be considered its additional option.

A pulse oximeter is necessary for people suffering from hypoxia.

Pulse oximeter - device medical purposes. Serves to determine two very important health indicators in a person: pulse and saturation. Saturation reflects percentage saturation arterial blood oxygen. Normally, this figure should be from 95 to 100%. It is measured using two light sources of the device, having different wavelengths, and a photosensor that captures light waves reflected from tissues. The obtained pulse and saturation results are displayed on the device’s display.

To measure pulse and saturation at home, portable devices are used, the sensor of which is most often attached to the earlobe or fingertip. Working with the device is very simple: you need to fix the sensor in in the right place, press the device button and wait a few seconds until two indicators appear on the display: pulse and saturation.

While many families have a tonometer, this does not apply to a pulse oximeter. They buy it if one of the family members has such illnesses, when it is vitally necessary to carefully and almost daily evaluate the pulse and saturation. For example, there is often such a device in families where the child has a severe heart defect or serious illness lungs. Among “adult” diseases come to the fore chronic diseases heart, blood vessels and lungs, when the patient’s condition is characterized by instability and tendency to frequent deterioration.

One of the advantages of the device is that the device will emit sound signal alarms when saturation and pulse indicators go beyond their normal limits. Before purchasing a pulse oximeter, you should consult your doctor, and before using the device, carefully read the instructions.

By the way, there is a state-of-the-art device for babies with special health conditions that records both pulse and saturation. These are “smart” booties that are put on the baby’s legs and constantly monitor important indicators his health. The device itself connects to a smartphone through an application, which makes it possible to remotely monitor the necessary parameters as needed.

Fitness watches for any color and budget

Heart Rate Gadgets for Runners and Fitness Enthusiasts

If blood pressure monitors and pulse oximeters (medical devices) are used by people with health problems, then modern gadgets that can measure pulse are mainly popular among healthy people. We'll talk about athletes and fitness enthusiasts who monitor their heart rate to find correct mode workouts and their intensity.

Fitness bracelet and fitness tracker

These are compact devices that look like watches or bracelets. They are fixed on the wrist. A person walks around with such a gadget all day (walks, eats, sleeps, works, trains), and smart bracelet Meanwhile, it closely monitors the activities of its owner and records some indicators of his health, including his pulse. The heart rate indicator is displayed.

In addition to the pulse, such devices measure steps taken, calories burned, keep a food diary, measure saturation and blood pressure, monitor the sleep of its owner and wake him up at right time, control the process of his training. But not all fitness trackers are the same: the set of main and additional options differs between different models.

Apple Watch and other fitness watches

This is one of the most popular among athletes. The watch performs many functions: among other things, it has an accelerometer and a gyroscope that track the movement of the body in space during the day, as well as an optical sensor that measures heart rate. The heart rate indicator is displayed on the watch display, which is so convenient to look at directly during training.

Fitness headphones

Many athletes, especially runners, love to train to music. Surprisingly, you can listen to your favorite music and monitor your heart rate at the same time. For this purpose, special wireless headphones have been developed that are compatible with a smartphone, fitness watch or fitness bracelet. The headphone device includes an optical sensor that records your heart rate directly inside auricle. Heart rate indicators are displayed on the display of the gadget that is connected to headphones or even several similar devices.

There are many ways to assess a person's well-being. Do you feel like you have a fever? Thermometer under the mouse. Measure your blood pressure? Tonometer to help. How, for example, can you find out whether your heart is working normally or whether you should run to the doctor? Most affordable way- pulse!

In this article you will learn how to correctly measure the pulse on the arm, neck and other parts of the body, as well as how to interpret the results obtained.

Pulse measurement algorithm

Surely you have seen more than once how, during an examination, a nurse or doctor deftly feels the desired artery in the wrist. A few seconds of concentrated calculations and we already know how often our heart beats. And there really is nothing complicated about it. You just need to know a few simple rules counting the pulse and those points where it is easiest to do this.

How to measure pulse on your hand

So, how to measure the pulse on your hand yourself? All you need for this is a stopwatch and your own fingers.

Free your hand from anything that may interfere with blood circulation: watches, chains, etc. Roll up the sleeve higher, but so that it does not crush the blood vessels.
Place your hand on a table or other flat surface with your palm facing up. Using the index and middle fingers of your other hand, find the radial artery - it is located on the wrist, under the base of the thumb. Press it lightly until you feel the impacts.
Record the time and start counting the kicks. It's best to do this within a minute. However, you can count in 30, 15 or 10 seconds. Just remember to then multiply the result by 2, 4 and 6, respectively.
Read the pulse on your hand 2-3 times a day at the same time and do not forget to write down the readings. If palpitations are clearly visible, consult a doctor.

When measuring, remember to maintain good hygiene. Before and after the procedure, be sure to wash and dry your hands.

There are a couple of points to remember when carrying out the procedure:

it is better to use the left hand - its artery is located closer to the heart, so it is easier to track the heart rate on it;
don't take measurements thumb. It has its own rather strong pulsation, which can cause you to get erroneous results;
If there is a danger of heart disease, it is better to play it safe and count the beats per minute. This way the result will be more accurate.

However, it is not always easy to find the radial artery. This is especially difficult to do if a person has such weak heartbeat that it seems as if he has no pulse at all. In such cases, another, much more visible artery comes to the rescue.

How to measure the pulse on the carotid artery

In addition to the pulse on the hand, the number of heart beats per minute can be found using carotid artery. The calculation algorithm in this case is as follows:

Measurements on the carotid artery should be taken in a lying position. IN as a last resort– lean back in your chair.
Gently move your index and middle fingers from lower jaw to the throat until you feel a depression. In this place you can feel the most strong pulsation.
Time it on a stopwatch and count the number of beats per minute.

Attention! Please note that it is the carotid artery that supplies the brain with blood. Don't press too hard to reduce the pressure. Do not clamp both arteries at once.

Other ways to measure heart rate

In addition to the radial and carotid arteries, there are several other places where you can feel the pulse. Among them:

temporal artery;
between the edge of the lower jaw and the mouth;
armpit area – axillary artery;
elbow bend - brachial artery;
popliteal artery;
inner thigh.
feet - just below the ankle.

Wherever you need to measure your heartbeat, the procedure remains the same. Feel the pulse, and then it’s a matter of practice.

And you can also use an electronic tonometer - the device will calculate everything for you. You don’t have to look for arteries and note the time. Just attach the tonometer, and a special sensor will analyze your heartbeat and give you finished result. Such devices can even determine blood pressure based on your pulse.

And although this method is certainly the simplest, it is, unfortunately, necessary medical equipment not always at hand. Therefore, knowing how to measure your pulse with your fingers is essential.

What heart rate is considered normal?

So, you found the right artery, measured the pulse and carefully wrote down the result in a notebook. But what to do with these indicators? How do you know what the normal beat frequency is? Is it different for an adult and a child?

There are fixed values that determine the rate of heart rate. It depends primarily on the age of the person.

newborn: 120-140 beats per minute;
children under one year: up to 130 beats per minute;
children from two to seven years old: from 75 to 100 beats per minute;
children from 7 to 14 years old: 75-90 beats per minute;
adult up to 30 years old: up to 80 beats per minute;
trained person, athlete: 40-60 beats per minute;
from 30 to 50 years: 60-85 beats per minute;
over 50 years old: up to 95 beats per minute.

Indicators affecting pulse

Remember that on cardiovascular system and accordingly, the pulse can be influenced by many factors, so the measurement results can change their values even within one day. He may be affected powerful emotions that a person experiences, or certain drinks, such as coffee or alcohol, and hot food. Hunger and taken shortly before the procedure hot bath also changes the heartbeat readings.

It is worth taking into account both the position of the subject’s body and his well-being: high temperature significantly accelerates pulsation in the arteries. Even the time when the procedure is performed can have an effect: from 8 to 12 am, as well as from 18 to 20 pm, the maximum heart rate is observed. Optimal time for heart rate measurements - a couple of hours after waking up.

When playing sports

And of course, the heart rate increases significantly during sports. It is important not to overdo it and not exceed the maximum heart rate per minute.

And although this value is strictly individual, there is a formula for its approximate calculation for an adult. To do this, subtract your age from 220. This way you will get the maximum value of heart rhythm. Multiply the result by 0.7 and find out optimal value pulse By staying within its boundaries, you can protect yourself from negative consequences physical activity.

Diagnostics by pulse

However, if there are obvious reasons why the heart rate differs from the norm, then it is quite possible that the person has problems with the heart. Using the pulse you can find out about possible development diseases such as heart disease, arrhythmia, heart attack, stroke or hypertensive crisis.

If the number of beats per minute is higher than normal, in medicine it is called tachycardia. If lower - bradycardia. Both - serious reason consult a specialist.

Rapid pulsation

The causes of tachycardia can be very different. Very often it is associated with passively life, overweight or lack of oxygen in the body, for example, due to lung problems. An increased heart rate can be associated with stress and, as is not trivial, bad habits.

Tachycardia can be accompanied by headache and heart pain, suffocation or arrhythmia, so do not neglect treatment. If the pulse deviates from the norm to a greater extent, you should refrain from coffee, alcohol and medications that affect the functioning of the heart.

Be sure to visit a cardiologist so that he can determine the presence or absence of more serious pathologies. To prevent tachycardia, try to reduce the amount of “junk food” in your diet and spend more time outdoors.

Slow pulsation

A slow heart rate may be the result of chemical poisoning, severe hypothermia, fasting, or problems with thyroid gland. Quite often, bradycardia develops in trained athletes.

With a low heart rate, a person often experiences drowsiness, general fatigue, weakness and lethargy.

Important! Bradycardia can cause fainting or even cardiac arrest! If you experience a decrease in heart rate, be sure to visit your doctor.

Regular recording of heart rate measurements can help determine early various pathologies and diseases. For example, the pulse on the hand. What can the number of beats per minute on different hands tell you? Let's start with the left wrist:

Strong impacts under the base of the index finger may indicate problems with the digestive tract.
Frequent pulse under the middle finger indicates problems with the spleen or gallbladder.
The situation is the same with the ring finger - you should pay attention to the kidneys. This, by the way, also works on the right hand.

The right hand can give you no less information:

Strong pulsation under the index finger can be caused by a malfunction in the cardiovascular system.
The base of your middle finger is your litmus test for liver function.

Important! Of course, these are far from the most accurate indicators, but only one of additional ways diagnose your pulse at home.

Do not forget that a correct diagnosis can only be made in a hospital. Therefore, even if there are deviations from the norm, there is no need to panic. After all, as mentioned above, the heart rate is influenced by the most various factors, ranging from age to time of day.

Yu. V. Khmelevsky

Despite the solid hardware modern medicine, it cannot surpass, today, the pulse diagnostic method used in traditional medicine. This is the highest diagnostic method that has been achieved traditional medicine over the millennia-long history of its existence. By examining a patient’s pulse, a traditional medicine doctor can tell: what whether the patient has been ill throughout his life, what disease and in what phase he has today, and what awaits him in the future if the patient does not take care of his health. The pulse was used to determine the sex of the child and the time of death of the person, and much more. A doctor of traditional medicine spends many years mastering such diagnostics. But we will try to quickly teach you a simplified version of such diagnostics. You will not become a diagnostic expert, you will not learn to make a diagnosis, but you will learn to determine your temperament; whether you have a disease or are healthy; if your health worsens, in which part of the body the disease nests, if any; what organs are possibly “affected”. We will also teach expectant mothers how to determine the sex of their child.

Mastering the basic pulse technique requires attention and daily practice.

Prerequisites

You should not check your pulse:

Immediately after eating food, alcohol or medication.
With an acute feeling of hunger.
After a hard physical work or intense mental work.
After the massage.
After bathing or sex.
After being near the fire, in the sun or frost.
Poor sleep.
IN critical days(among women).

Time for pulse diagnostics

Many years of practice have shown that the best time for pulse diagnostics is considered to be between 11-13 hours, i.e. between breakfast and lunch. At this time of day, the pulse is calmer and more stable.

Determination of radial pulse

The best place to feel the pulse is on the radial artery at a distance of the width of a thumb below the first fold of the skin of the wrist at the bone.

The radial pulse is checked with three fingers: index, middle and ring (see figure).

The pulse readings on the right and left wrists are not the same, so it is better to check the pulse on both hands.

To check your own pulse, hold your hand with your wrist slightly bent. Grasp your wrist tightly with your other hand. bottom side. Place three fingers on your wrist, on the radial artery, in line with very little space between them. Apply gentle pressure just below the radius (metacarpal bone) and feel the pulse points. Each finger should clearly feel the pulse wave. Then release your finger pressure a little to feel the different movements of the pulse.

Determining your temperament by pulse

To determine innate temperament, i.e. those properties that you inherited from your parents, you can use the questionnaire given at the beginning of our book. But a person’s temperament does not remain the same throughout his life. It may change depending on age, during illness. The temperament that you have at a given day and hour, let's call it acquired (it can also coincide with innate), can be determined using a simple technique (applicable for practically healthy people). To do this, you need to measure your pulse as accurately as possible. Pulse should be measured in calm state, at normal temperature and ambient humidity, better in the morning, after departure natural needs and before breakfast.

The pulse can be measured in the following arteries: temporal (above the temples), carotid (along the inner edge of the sternocleidomastoid muscle, under the jaw), brachial (on inner surface shoulder above the elbow), femoral (on the inner surface of the thigh at the junction of the leg and pelvis), popliteal. Usually the pulse is measured at the wrist, with inside hands (on the radial artery), just above the base of the thumb.

If your pulse rate lies in the range of 76-83 beats per minute and the quality of the beat in the fingers when the artery moves, the type of pulse beat is very strong, active, regular, spasmodic, reminiscent of the movement of a jumping frog, then you are choleric.

If your pulse rate is in the range of 68-75 beats per minute, the type of pulse is very strong, active, regular, spasmodic, reminiscent of the movement of a jumping frog, then you are sanguine.

If your pulse is less than 67 beats per minute and the type of pulse beat is weak and regular (its movement resembles the movement of a swimming swan), then you are a phlegmatic person.

If the pulse rate is more than 83 beats per minute, the type of pulse is weak and irregular, wave-like, like the movement of a snake, then you are melancholic.

Determining health status by the number of pulse beats

Whether a person is healthy or sick can be determined by the number of pulse beats. For a healthy, ordinary person (who has not achieved the highest spiritual perfection), for each respiratory cycle, including exhalation, pause and inhalation, there are from 4 to 6 pulse beats (average 5). If the pulse is less (for example, 3 beats) or more (7 beats), then this indicates a dysfunction certain body and is an indication to see a doctor. Pulse from 3 to 1 indicates functional failure organ (the lower the numbers, the more pronounced the deficiency) and the onset of cold illness (compensated by eating hot food and warming foods, see “Health Science”). Moreover, three strikes - average cold, two strikes - extreme cold and one strike - excessive cold or the pulse of death. A pulse from 7 to 10 indicates functional activity organ (the higher the numbers, the greater the activity) and the appearance of fever (compensated by taking cooling products). Moreover, seven blows means medium heat, eight blows means high fever, nine blows - extreme heat and ten blows - excessive heat or pulse of death. For a hundred beats, pulse healthy person should be even in all its parameters - strength, fullness, tension, resembling a string of even pearls. An irregular pulse indicates illness.

Normal heart rate for different age categories:

Determining the location of the disease by pulse

If your health has worsened and you don’t know what’s happening to you, where the source of your troubles lies, do a pulse diagnosis for yourself. Before diagnosing, follow all the recommendations above.

At the beginning of the pulse diagnosis, clasp your left wrist with your right hand, as shown in the figure. Follow all the recommendations described above. Let us remind you that the pad of each finger should clearly feel the pulse wave. Determine which of the three fingers the strong pulsation is felt under, and remember this. Then grab your right wrist with your left hand and determine which finger feels the strongest pulsation. In this case, a strong pulsation can be felt only under one finger on one of the hands.

Finger position	Left hand		Right hand
Finger position	Superficial pulse	Deep pulse	Deep pulse	Superficial pulse
Index	In men
	Small intestine	Heart	Lungs	Colon
	Among women
	Colon	Lungs	Heart	Small intestine
Average	Stomach	Spleen	Liver	Gallbladder
Nameless	Genitals	Kidney (left)	Kidney (right)	Bladder

This information is already enough to determine the area of the body where the cause of your discomfort may lie.

If strong pulsation is detected on the left wrist, then the lesion should be looked for on the left half of the body, and if the pulsation is stronger on the right wrist, then it should be looked for in right half bodies.

If a strong pulsation is detected under the pad of the index finger (left or right), then the top part body, including head, heart, lungs. If there is a strong pulsation under the pads of the middle fingers - diseases of the stomach, liver and other diseases of the middle part of the body and according to the pulses under the pads ring fingers– kidney and lower back diseases, i.e. diseases of the lower body.

If you feel a strong pulsation under the index finger on your left hand, then damage to the heart or small intestine is possible, and if on your right hand, then to the lungs or large intestine. This is true for men, but vice versa for women (see table). If there is a strong pulsation under the middle finger of the left hand, the spleen or stomach is affected, and if on the right hand, then the liver or gallbladder. If there is a strong pulsation under the ring finger of the left hand, then damage to the left kidney or genitals is possible. If on the right hand, then the right kidney or bladder.

We are practically very close to the goal, but in order to accurately indicate the affected organ, certain experience and skills are required.

Try to learn to distinguish the strength of pulsations when touched superficially (superficial pulse) and when pressing strongly with the upper edges of your fingers (deep pulse).

If you feel a strong pulsation when you touch it superficially (superficial pulse) with the index finger of your right wrist, then the problem is in the large intestine. If in the same position with strong pressure (with the upper edge of the finger) a deep pulse is strong, then there is a blockage in the lungs.

A strong pulsation under the middle finger on the right wrist may indicate a condition of the gallbladder (with superficial touch, i.e. superficial pulse) and liver (with strong pressure, i.e. deep pulse).

Strong pulsation under the ring finger located on the right wrist may indicate a condition of the bladder (with superficial touch) and the right kidney (with strong pressure).

A strong pulsation under the index finger on the left wrist may indicate the condition of the small intestine (with a superficial touch) and the heart (with strong pressure).

A strong pulsation under the middle finger on the left wrist may indicate a condition in the stomach (with superficial touch) and spleen (with strong pressure).

Strong pulsation under the ring finger located on the left wrist may indicate the condition of the genitals (with a superficial touch) and the left kidney (with strong pressure).

Let's give some more recommendations that may help you. In diseases of heat, according to Tibetan traditional medicine, they are affected by the following bodies: heart, lungs, liver, spleen, kidneys, and in case of cold diseases - thin and colon, stomach, gallbladder, bladder, ovaries or testicles. So, for example, you feel a strong pulsation on your right hand, under your middle finger. This area is responsible for the liver and gall bladder. Which of these organs is affected? If you feel unwell and have a fever, your liver is affected. And if you start to freeze, then the gallbladder is to blame.

When performing pulse diagnostics, it is also necessary to take into account the season of the year. For example, in the spring the pulse under the pad of the middle finger of the right hand increases. In summer, the pulse increases under the pad of the index finger of the left hand (for men) and the right hand (for women). In autumn, the pulse increases under the pad of the index finger of the right hand (for men) and the left hand (for women). In winter, the pulse under the pads of the ring fingers increases.

Determining the sex of a child by the pulse of a pregnant woman

If a pregnant woman has a strong pulse on her right hand, in the area of her ring finger, a boy will be born, and if the pulse on her left hand is strong, in the same area, a girl will be born.

Literature:
Yeshe Donden. Health through balance. M.: LLP “THE WAY TO YOURSELF”, 1996, 192 p.
Ayurveda: A Guide to practical methods. /Under general ed. IN AND. Borodkina. – Mn.: “Vida-N”, 2000, 320 p.
Atlas Tibetan medicine. A set of illustrations for a 17th-century Tibetan medical treatise. Album. /Coll. Auto. M.: Galart, 1994, 592 p.
“Zhud-shi” - a monument of medieval Tibetan culture, Trans. from Tib. Preface D. B. Dashieva, S. M. Nikolaeva, Novosibirsk: Science. Sib. Department, 1988, 349 p.

If the pulse is the same in both hands, then the study of its characteristics is carried out on one hand.

The pulse in symmetrical areas may be various(p.differents). Pathological processes (unilateral anomalies of structure and location peripheral vessels, compression of arteries by tumors, scars, enlarged lymph nodes, aneurysm of the aorta and its branches, tumors of the mediastinum, retrosternal localization of goiter) can deform arterial vessel along the path of pulse wave propagation. A unilateral decrease in pulse filling appears with or without a simultaneous delay in the pulse wave.

Popov-Savelyev symptom: the pulse on the left arm is less full (especially in the position on the left side) with mitral stenosis, since the hypertrophied left atrium compresses the left subclavian artery.

· Pulse rhythm.

After determining the sameness (uniformity) of the pulse in both hands, determine the rhythm.

Rhythm pulse does not depend on the condition of the arteries, but reflects the nature of contraction of the left ventricle of the heart.

Pulse rhythmic, regular (p.regularis) - pulse beats are felt at regular intervals.

Pulse uniform – pulse waves are equal to each other.

Impaired pulse regularity - arrhythmic pulse ( p.irregularis).

Pulse waves become different in size - uneven pulse.

Some types of arrhythmias are relatively easily detected by palpation. These include:

Respiratory arrhythmia - pulse at breathing movements sometimes it quickens (when you inhale), sometimes it slows down (when you exhale). It is characteristic that by holding the breath this type of arrhythmia is eliminated;

Extrasystole - pulse waves, smaller in magnitude, appear earlier than usual ( premature contractions), followed by a longer pause (compensatory pause);

Atrial fibrillation– the pulse is arrhythmic, its individual waves are of different sizes;

Paroxysmal tachycardia - suddenly begins in the form of an attack and also ends suddenly, the pulse reaches a frequency of more than 140 beats per minute, which does not happen with other rhythm disturbances;

Third degree atrioventricular block is a very rare (less than 40 beats per minute), regular and constant pulse rate.

· Pulse rate.

For determining frequencies pulse, three fingers of the palpating hand (second, third, fourth) are placed on the radial artery and the number is counted pulse beats for 15 seconds or 30 seconds and the resulting number is multiplied by 4 or 2, respectively (with a rhythmic pulse). If the pulse is arrhythmic, count for at least 1 minute.

Normal heart rate is 60-90 per minute.

Normally, the pulse rate fluctuates significantly depending on age, gender, and height. In newborns, the pulse rate reaches 140 beats per minute. The pulse rate is often higher the higher the patient is.

In the same person, depending on the time of eating, movements, depth of breathing, mental state, body position, heart rate is constantly changing.

Pulse frequent(p.frequens) – pulse rate more than 90 per minute.

Pulse rare(p.rarus) – pulse rate less than 60 per minute.

A rapid pulse occurs during physical and mental stress, when sinus tachycardia, heart failure, drop in blood pressure, anemia, thyrotoxicosis, attack paroxysmal tachycardia, at pain. When body temperature rises by 1ºC, the pulse rate increases by 8-10 beats per minute.

A rare pulse occurs during sleep, in athletes, and with negative emotions. It is an indicator of pathology in case of blockade of the conduction system of the heart, hypothyroidism, and increased intracranial pressure, with jaundice (parenchymal and mechanical).

· Pulse deficiency.

Pulse deficiency– the number of heart contractions and the number of pulse waves in the periphery may not coincide (with atrial fibrillation).

Pulse deficiency is determined by palpation and auscultation in patients with arrhythmia.

There are two ways to determine pulse deficit.

First way. ABOUT At the same time, place a stethoscope on the area of the apex of the heart to count the number of heartbeats, and palpate the pulse on the radial artery with the other hand (Fig. 5.5.2).

After counting the pulse rate for a minute, for the next minute those heartbeats that were not accompanied by the appearance of a pulse wave on the radial artery are counted - that is, a pulse deficit.

Second way. Within a minute, the number of heartbeats is counted, the second minute - the pulse rate on the radial artery (Fig. 5.5.2). Then the pulse rate is subtracted from the number of heart contractions and the result is a pulse deficit.

The presence of a pulse deficit indicates weakness of the contractile function of the heart - not all contractions of the left ventricle are accompanied by the formation of a pulse wave in the periphery.

· Condition of the vascular wall.

Definition state of elasticity of the vascular wall.

To determine the condition of the wall of the radial artery, three fingers of the palpating hand (second, third, fourth) are placed on it. First, the artery is compressed with the second finger until the reverse flow of blood from the vessels of the hand stops, and then the blood is squeezed out of the vessel with the fourth finger and squeezed until the passage of the pulse wave stops (Fig. 5.5.3). The third finger lies freely on the empty artery and rolls along the wall of the vessel with sliding movements.

Normally, the arterial wall is soft, elastic, smooth.

With atherosclerotic hardening of the artery, a dense, rough, twisted tube is felt under the third finger.

· Pulse filling.

Filling pulse depends on the stroke volume, the total amount of blood in the body and its distribution throughout the vascular system.

To determine the filling of the pulse, three fingers of the palpating hand (second, third, fourth) are placed on the radial artery. First, the artery is compressed with the second finger until the reverse flow of blood from the vessels of the hand stops, and then the blood is squeezed out of the vessel with the fourth finger and squeezed until the passage of the pulse wave stops. The third finger rests freely on the empty artery. The fourth finger is released, and the pulse wave, passing under the third finger, lifts it and hits the second. The filling of the pulse is assessed by the degree of elevation of the third finger (Fig. 5.5.4.).

Normal pulse is satisfactory filling. In this case, an indentation of the soft tissues of the finger is felt without lifting it.

Full pulse (p.plenus) – vibration of the entire palpating finger is felt.

A full pulse occurs in athletes during sports competitions and during physical activity.

Empty pulse (p.inanis) – raising the vessel wall does not cause a sensation of indentation of the soft tissues of the palpating finger.

Pulse filling decreases with a decrease in cardiac output (left ventricular failure) and a decrease in the volume of circulating blood (blood loss).

An empty pulse occurs with hypotension, acute cardiac vascular insufficiency(collapse, cardiogenic shock), aortic stenosis.

· Pulse voltage.

Voltage pulse depends on the value of systolic blood pressure and the tone of the vascular wall.

The degree of pulse tension is judged by the force that is necessary to compress the artery until the pulsation completely stops.

To determine the pulse voltage, the second - third - fourth fingers of the palpating hand squeeze the artery until the pulsation in it stops (Fig. 5.5.5.).

Normal pulse is of satisfactory tension. The pulsation can be suppressed by applying a certain amount of force.

Solid pulse (p. durus) – preservation of the pulsation of the artery when it is strongly compressed.

A hard pulse occurs when arterial hypertension, atherosclerosis of the arteries.

Soft pulse (p. mollis) – required minimum effort to suppress the pulse.

A soft pulse occurs with hypotension, acute bleeding, mitral stenosis, insufficiency mitral valve, stenosis of the aortic mouth.

· Pulse value.

Palpation evaluate size pulse is very difficult, and therefore about it judge indirectly based on a summary assessment of the filling and voltage of the pulse wave.

The pulse value is influenced by pulse pressure and arterial filling.

By size they are distinguished:

big pulse (p.magnus) – pulse of good filling and tension;

small pulse (p.parvus) – pulse of low filling and tension;

filiform pulse (p. filiformis) – a barely palpable small and soft pulse.

Big pulse occurs when the work of the heart increases (failure aortic valve, thyrotoxicosis, fever). In these conditions, the stroke volume of blood and the frequency of pressure fluctuations in the artery increase or the tone of the arterial wall decreases.

A small pulse occurs when the stroke volume of the left ventricle decreases and the pulse pressure decreases. It can occur when there is an obstruction between the heart and peripheral arteries - aortic stenosis or aneurysm.

Thread-like pulse occurs when large blood loss, acute vascular failure (collapse), acute heart failure (cardiogenic shock).

· Pulse shape.

Form The pulse is determined by a sphygmogram and depends on the speed and rhythm of the rise and fall of the pulse wave.

The pulse is distinguished by its shape:

Fast (r.celer),

Slow (r.tardus),

Dicrotic (p.dycroticus).

Fast pulse - jumping, rapidly increasing, may be the result of increased stroke volume of the left ventricle (aortic valve insufficiency, thyrotoxicosis, anemia, fever), pathologically rapid ejection of blood (open ductus arteriosus, arteriovenous fistulas).

Slow the pulse is characterized by a slow rise and fall of the pulse wave and occurs with slow filling of the arteries (aortic stenosis, mitral stenosis).

Dicrotic the pulse consists of two systolic peaks: the main pulse wave is followed by a new, like a second (dicrotic) wave of lesser strength, they correspond to only one heartbeat. The second wave of the pulse is caused by the reflection of blood in peripheral parts arteries and the more, the lower the tone of the arterial wall. Dicrotic pulse indicates a drop in tone peripheral arteries while maintaining the contractile function of the myocardium ( severe infections, collapse). It also occurs in dilated cardiomyopathy, aortic insufficiency with very low stroke volume.

Venous pulse

Venous pulse reflects fluctuations in the volume of veins as a result of systole and diastole of the right atrium and ventricle, when the outflow of blood from the veins into the veins slows down and accelerates right atrium(respectively, swelling and collapse of veins).

The venous pulse is detected and assessed by inspection, palpation and venography.

The study of the venous pulse is carried out on the veins of the neck, always simultaneously examining the pulse in the carotid artery.

Normally, there is a subtle and almost imperceptible pulsation.

Right atrial, or negative venous pulse – normal bulging jugular vein precedes the pulse wave on the carotid artery.

Right ventricular, positive The venous pulse becomes due to tricuspid valve insufficiency. Due to a defect in the tricuspid valve, there is a reverse flow of blood from the right ventricle into the right atrium and veins.

Such a venous pulse is characterized by pronounced swelling of the jugular veins simultaneously with a rise in the pulse wave in the carotid artery. If you press the jugular vein in the middle, then its lower segment continues to pulsate. More accurate ideas about the venous pulse can be obtained from a venogram.

Capillary pulse

Under capillary pulse refers to the periodic redness (in the systole phase) and blanching (in the diastole phase) of the nail bed with light pressure on the edge nail phalanx(Fig.5.5.6).

You can detect a change in color of the hyperemic spot obtained after rubbing the skin on the forehead, as well as on the mucous membrane of the lips when pressing on them with glass (Fig. 5.5.6).

Based on their origin, a distinction is made between true and precapillary pulses.

Cause true capillary pulse - varying degrees filling of the veins during the systole and diastole phase of the heart, due to which the arterial knee of the capillaries pulsates rhythmically. Appears in individuals young with thyrotoxicosis, high temperature, after applying thermal procedures.

Precapillary pulse (Quincke pulse) occurs only in patients with aortic valve insufficiency. It is caused by release in the systole phase large quantity blood into the aorta and transmission of pulse oscillations to arterioles rather than capillaries. Combined with pulsation of large arteries (“pulsating man”).