Different pulse on the hands of the cause. Different blood pressure on the hands: causes

Article publication date: 12/31/2016

Article last updated: 12/18/2018

From this article you will learn: from what happens different pressure on hands; when it's okay and when it's not. Why pressure must be measured on both hands.

Many people who measure and control blood pressure do not do it right if they only take tonometry on one arm. But even those who do it 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 on the left and right hand can be absolutely normal as well as 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. Upon learning of this, many people in whom such a condition may be a variant of the norm begin to panic and treat a non-existent disease on their own, although in fact nothing needs to be done - because they are healthy. At 15–20%, the difference in pressure on the hands is really alarm signal diseases that require immediate clarification of the cause of occurrence and special treatment.

To understand the situation will help a specialist - a therapist or family doctor. If necessary and depending on the suspected cause, they will appoint a consultation with other specialists: a cardiologist, vascular surgeon, neuropathologist. Correct diagnosis and treatment not only normalize blood pressure, but also prevent more serious threats . It is possible to heal.

How to figure out if it's a norm or a pathology

If you, having measured the pressure in yourself, loved ones or any other people, noticed the difference in numbers between the right and left hands, pay attention to a few facts that are described and deciphered in the table:

What to pay attention to	Features of the influence of the factor on pressure
The magnitude of the difference (by how much mm Hg the indicators differ)	Permissible fluctuation range - 5-10 mm Hg. Art. both upward and downward. How more difference, the more it says about the pathology.
On which arm BP is changed	Both in the norm and in pathology, pressure asymmetry is recorded equally often both on the right and on the left.
Increased or decreased pressure	If it is normal or high on one hand, and even more on the other, the problem is less dangerous than a decrease in numbers below the norm on one side against the background of normal ones on the other
Age	In adolescents and older people age group BP difference is more common
Right handed or left handed	Basically, the pressure rises on the main working arm
Is the person associated with active sports and physical work	If so, it is more likely that the BP asymmetry is their result.
Presence of complaints and symptoms	If they are, it means pathological character pressure asymmetries

If you rarely measure pressure, but because of some complaints or for the sake of interest, be sure to do this on both hands. If you conduct tonometry daily, then at least once a month measure the indicators on the right and left.

Who and why can be calm

From the table above, we can conclude that the discrepancy between blood pressure between the right and left hand 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, data interpretation must be approached individually.

On which arm should the blood pressure be higher?

The asymmetry of pressure in the form of a one-sided increase is less dangerous than a one-sided decrease if the numbers on the second hand are normal or increased (from 100/60 to 140/90 and above).

Increased pressure may be on the left arm

In healthy young right-handed people who are not associated with intense physical activity, the pressure on the left hand may be higher than on the right. In actively working left-handers, this difference can 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 departs from less large vessel- the brachiocephalic trunk, so the pressure in it is lower.

Increased pressure may be on the right arm

In right-handers associated with active physical activity, the indicators on the right should be higher than those on the left, but within the allowable 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 on the lookout

Suspect that different blood pressure on 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 limbs is impaired:

Atherosclerosis - cholesterol plaques.
Thrombosis and thromboembolism - the formation of blood clots on the walls or their introduction from the heart.
Aorto-arteritis - inflammation of the vascular wall.
Aneurysm is a saccular expansion and destruction of the arterial wall.
Scalene muscle syndrome is a thickening of the muscle fibers through which the subclavian artery passes.
Tumors of soft tissues and bones in the area chest and shoulder.
Trauma and vascular surgery.

Possible manifestations

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

The brush is losing power.
Fingers become cold, pale and numb.
Possible cyanosis of the fingertips or the entire hand.

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

headache;
dizziness;
drawn out speech;
memory loss;
paralysis of half of the body;
face distortion.

Symptoms of circulatory disorders in 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. So if you want to appreciate the flow hypertension and effectiveness of treatment antihypertensive drugs focus only on him.

Who needs treatment

If the pressure difference between the left and right hand does not exceed 10 mm Hg. st - treatment is not 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 therapist. You may need specialized treatment under the supervision of a vascular surgeon, neuropathologist, cardiologist.

This may require:

Regular tonometry (measurement of indicators).
Taking drugs that restore vascular patency, slow down the progression of atherosclerosis or aortoarteritis, thin the blood and improve blood supply.
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, setting stents and even replacing altered arteries with an artificial prosthesis.

Treatment for pressure difference between right and left arm

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 - it is possible to recover.

Forecast

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

If, simultaneously with a violation of the blood supply to the arm, 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 marked difference in pressure across the arms often precedes these dangerous diseases which in 50% of cases end in the death of patients.

Many devices are able to measure the pulse. But how accurate are their readings?

What is a pulse?

Some mistakenly believe that the pulse and the frequency of contractions are the same, which is a delusion. What is the difference?

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

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

Human 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. In females, the pulse is faster than in men. In people who are actively involved in sports, the pulse is rarer.

Why does a person measure the 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. An independent measurement of the pulse among a simple layman usually pursues only one goal: to find out its frequency.

At what pathological conditions does your heart rate increase?

With diseases of an infectious nature;
With congenital and acquired heart defects;
In violation of cerebral circulation;
For a number of diseases endocrine organs, nervous system;
With a decrease in hemoglobin and red blood cells in the bloodstream (with anemia);
For some tumor processes and etc.
When does the pulse decrease?
When taking certain medications;
Athletes and those who are engaged in heavy physical labor.
In case of poisoning, with a stomach ulcer;
With a decrease in thyroid function (hypothyroidism);
With inflammation of the heart muscle;
With myocardial infarction, etc.

Under these conditions, a person does not measure his pulse on his own, and this is not required. More often, athletes who control the intensity of training, and people suffering from diseases of the heart and blood vessels regularly measure their pulse. According to the pulse rate, they can draw conclusions about their condition on this moment and spot problems early. Next, we will discuss how to correctly measure the pulse, and what devices will facilitate this task.

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

The pulse measurement is carried out in different situations: at rest, during exercise, after exercise; as well as in different positions of the subject: standing, lying, sitting. It all depends on the purpose of the study. But regardless of the reason for which the pulse will be measured, the technique for such a study is the same.

Anyone can learn to measure the pulse on their own. There is nothing difficult in this. The pulse is measured on those arteries that are located close to the surface of the body: the brachial, radial, carotid, femoral, etc. Most often, the pulse is measured on radial artery i.e. 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 is felt on the right and left hands in the same way. The radial artery runs from the inner (palmar) side of the wrist from its lateral edge, that is, along the side where the thumb is located. You don’t 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 held at the level of the heart.

In order to correctly measure the pulse on your hand, you need to put the wrist of one hand (for example, left) with the back side on the palm of your hand (in our example, right). Then it is necessary to clasp the wrist of the left hand with the fingers of the 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 pillow index finger the right hand is closest to the wrist joint.

Under the fingertips, there will be a radial artery, on which pulse waves will have to be probed. After that, it is worth a little pressure with the fingertips on the wrist in the downward direction and towards radius(passes from the side of the thumb).

How does the pulse feel? Under the fingertips (especially the index and middle fingers), an arterial wall oscillation (pulse wave) will be felt that occurs at regular intervals. Within a minute, it is worth calculating how many pulse waves will be felt. It is also quite easy to appreciate 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, it is worth counting the pulse in a minute.

How to measure the pulse on the hand of another person?

Another person has exactly the same technique for measuring the pulse. The person who takes the measurement wraps his hands around the wrists of the subject. 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 two hands at once. The method for measuring the pulse in a child is similar.

Tonometer is the most popular medical device.

Medical devices for measuring pulse at home

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

One of the differences between automatic, semi-automatic blood pressure monitors from a pulse oximeter is that with their help you can also find out the pressure. This made them popular in all Russian families. Depending on the type of cuff supplied with the device, measurements are taken on the brachial or radial artery.

To correctly measure the pulse and blood pressure, the patient needs to calm down and take comfortable position eg sit down. Then put the cuff of the device on the shoulder or wrist (according to the instructions and configuration), give the arm such a position that the cuff is at the level of the heart. Further actions slightly different depending on the type of device.

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

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

Before buying a tonometer, you should consult a doctor about 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 the tonometer is to measure blood pressure, and it is for this procedure that such a device is bought, and counting the pulse can be considered its additional option.

A pulse oximeter is essential for people suffering from hypoxia.

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

To measure heart rate and saturation at home, portable devices are used, the sensor of which is most often fixed on the earlobe or fingertip. It is very easy to work with the device: it is necessary to fix the sensor in right place, press the button of the device and wait a few seconds until two indicators appear on the display: pulse and saturation.

If so many families have a tonometer, then this does not apply to a pulse oximeter. They acquire it if one of the family members has such diseases, when it is vital 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 disease or serious illness lungs. Among the "adult" diseases come to the fore chronic diseases heart, blood vessels and lungs, when the patient's condition is characterized by its instability and a tendency to frequent deterioration.

One of the advantages of the device is that the device will emit sound signal anxiety when the saturation and pulse rates go beyond their normal limits. Before buying a puloximeter, you should consult a doctor, and before using the device, carefully read the instructions.

By the way, there is an ultra-modern device for babies with special needs, which captures both the 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 is connected to a smartphone through the application, which makes it possible to remotely monitor the necessary parameters as needed.

Fitness watch for any color and wallet

Heart rate gadgets for runners and fitness enthusiasts

If blood pressure monitors and a pulse oximeter (medical devices) are used by people with health problems, then modern gadgets that can measure the pulse are mainly popular among healthy people. It's 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 a watch or a bracelet. They are fixed on the wrist. A person walks with such a gadget all day (walks, eats, sleeps, works, trains), and smart bracelet meanwhile, closely monitors the activities of its owner and captures some indicators of his health, including the pulse. The heart rate is shown on the display.

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 their owner and wake him up at right hour control the process of his training. But not all fitness trackers are the same: the set of main and additional options differs for different models.

Apple Watch and other fitness watches

It is one of the most popular among athletes. The watch performs a lot of functions: including 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 the heart rate. The heart rate indicator is displayed on the watch display, which is so convenient to look at right in the process of training.

Fitness headphones

Many athletes, especially runners, like to train to music. Surprisingly, you can listen to your favorite music and monitor your pulse at the same time. For this, 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 registers the heart rate directly inside auricle. Pulse indicators are displayed on the display of the gadget that is connected to headphones or even to several similar devices.

There are many ways to evaluate a person's well-being. There is a feeling that the temperature? Mouse thermometer. Measure pressure? Tonometer to help. But how, for example, to find out if the heart is working normally or is it worth running 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.

Pulse measurement algorithm

Surely you have seen more than once how, during an examination, a nurse or doctor deftly gropes for the desired artery on 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 the pulse on the arm

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

Free your hand from everything that can interfere with blood circulation: watches, chains, etc. Roll up the sleeve higher, but so that it does not compress the vessels.
Place your hand on a table or other flat surface, palm up. Using the index and middle fingers of the other hand, find the radial artery - it is located on the wrist, under the base of the thumb. Press down lightly until you feel the impact.
Record the time and start counting the shocks. It is best to do this within a minute. However, you can count in 30, 15 or 10 seconds. Just don't forget to multiply the result by 2, 4, and 6, respectively.
Count the pulse on your arm 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, do not forget to follow the rules of hygiene. Before and after the procedure, be sure to wash and dry your hands.

There are a couple of things to keep in mind during 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;
do not measure thumb. It has its own rather strong ripple, 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. So 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 he seems to have no pulse at all. In such cases, another, much more noticeable 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:

It is necessary to take measurements on the carotid artery in the supine position. IN last resort- Lean back in your chair.
Gently move your index and middle fingers from mandible to the throat until you feel the indentation. In this place you can feel the most strong pulsation.
Record the time on the stopwatch, and count the number of beats per minute.

Attention! Keep in mind that it is the carotid artery that supplies the brain with blood. Do not press too hard on it, so as not to reduce the pressure. Do not occlude both arteries at once.

Other ways to measure your 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 have to measure the 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 keep track of time. Just attach the blood pressure monitor, and a special sensor will analyze your heartbeat and give you finished result. Such devices can even determine the pressure by pulse.

And although this method is certainly the easiest, but, unfortunately, necessary medical equipment not always available. Therefore, it is extremely important to know how to measure the pulse with your fingers.

What pulse 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 figures? How to understand what frequency of beats is normal? Does it differ between adults and children?

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

newborn: 120-140 beats per minute;
children up to a year: up to 130 beats per minute;
children two to seven years old: 75 to 100 beats per minute;
children from 7 to 14 years: 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;
30 to 50 years old: 60-85 beats per minute;
over 50 years old: up to 95 beats per minute.

Indicators affecting the pulse

Remember that on cardiovascular system and accordingly, many factors can affect the pulse, so the measurement results can change their values even within one day. It can be influenced powerful emotions that a person experiences, or certain drinks, such as coffee or alcohol, and hot food. Hunger and shortly before the procedure adopted hot tub also changes the indications of the heartbeat.

It is necessary to take into account both the position of the subject's body and his well-being: high temperature significantly accelerates the pulsation in the arteries. Even the time when the procedure is performed can affect: from 8 to 12 in the morning, and also from 18 to 20 in the evening, the maximum heart rate is observed. Optimal time for pulse 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. So you get the maximum value of the rhythm of the heart. Multiply the result by 0.7 and you will find out optimal value pulse. Staying within its boundaries, you can protect yourself from negative consequences physical loads.

Pulse diagnostics

However, if there are obvious reasons due to which the heart rate is different from the norm, then it is quite possible that a person has abnormalities in the work of the heart. With the help of 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 below - bradycardia. Both - serious occasion consult with a specialist.

Rapid pulsation

The causes of tachycardia can be very different. It is often associated with in a passive way life, overweight or lack of oxygen in the body, for example, due to problems with the lungs. Increased heart rate can be associated with stress and, as it is not banal, bad habits.

Tachycardia can be accompanied by headache and heart pain, suffocation or arrhythmia, so treatment should not be neglected. If the pulse deviates from the norm upwards, you should refrain from coffee, alcohol and drugs 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. As a prevention of tachycardia, try to reduce the amount of "junk food" in the diet and spend more time outdoors.

slow pulse

A slow pulse can be the result of chemical poisoning, severe hypothermia, starvation, 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 a doctor.

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

Strong bumps under the base of the index finger may indicate problems with the digestive tract.
Rapid pulse under the middle finger speaks of violations in the work of the spleen or gallbladder.
The same situation with the ring finger - you should pay attention to the kidneys. This, by the way, works on the right hand as well.

The right hand can give you no less information:

A 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, this is not the most accurate indicators, but only one of additional ways conduct a heart rate test at home.

Do not forget that a correct diagnosis can only be made in a hospital. Therefore, even with deviations from the norm, you should not panic. After all, as mentioned above, the heart rate is affected by the most different factors ranging from age to time of day.

Yu. V. Khmelevsky

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

Mastering the fundamentals of pulse examination technique requires attention and daily practice.

Preconditions

Do not check your pulse:

Immediately after a meal, alcohol or medication.
With an acute feeling of hunger.
After heavy physical work or hard mental work.
After the massage.
After bathing or sex.
After exposure to fire, sun or frost.
Sleeping badly.
IN critical days(among women).

Time of pulse diagnostics

Long-term practice has 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.

Radiation Pulse Determination

The best place to feel the pulse is on the radial artery at a distance of the width of the 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 the wrist, on the radial artery, in line with a very small gap between them. Press lightly just below the radius (metacarpal) and feel the pulse points. Each finger should clearly feel the pulse wave. Then slightly reduce the pressure of your fingers to feel the different movements of the pulse.

Determining your temperament by heart rate

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

The pulse can be measured on 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. The pulse is usually 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, according to the quality of the blow to 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 beat is very strong, active, regular, spasmodic, reminiscent of the movement of a jumping frog, then you are sanguine.

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

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

Determination of health status by the number of pulse beats

A person is healthy or sick can be determined by the number of pulse beats. For a healthy ordinary person (who has not reached the highest spiritual perfection), for every respiratory cycle, including exhalation, pause and inhalation, there are from 4 to 6 pulse beats (on average 5). If the pulse is less (for example, 3 beats) or more (7 beats), then this indicates a violation of the function certain body and is an indication to see a doctor. A pulse from 3 to 1 indicates functional insufficiency organ (the smaller the numbers, the more pronounced the insufficiency) and the appearance of a cold disease (compensated by eating hot food and warming foods, see "Health Science"). Moreover, three strokes - medium cold, two strokes - extreme cold and one stroke - 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 a fever disease (compensated by the intake of cooling products). Moreover, seven strokes means medium heat, eight strokes means high fever, nine strokes for extreme heat and ten strokes for excessive heat or the pulse of death. For a hundred beats, the pulse healthy person should be even in all its parameters - strength, fullness, tension, resembling a string of even pearls. Irregularity in the pulse beat indicates a disease.

Normal heart rate for different age categories:

Determining the location of the disease by pulse

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

At the beginning of the pulse diagnosis, grasp the wrist of the left hand with your right hand, as shown in the figure. Follow all the recommendations above. Recall that the pad of each finger should clearly feel the pulse wave. Determine under which of the three fingers a strong pulsation is felt, and remember this. Then clasp the wrist of your right hand with your left hand and determine under which of the fingers the strongest pulsation is felt. 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	Surface pulse	deep pulse	deep pulse	Surface pulse
index	In men
	Small intestine	Heart	Lungs	Colon
	Among women
	Colon	Lungs	Heart	Small intestine
Medium	Stomach	Spleen	Liver	gallbladder
Nameless	Sex organs	Kidney (left)	Kidney (right)	Bladder

This information is already enough to establish the area of the body where the cause of your ailment may be.

If a strong pulsation is determined 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 is necessary to look for right half body.

If a strong pulsation is determined under the pad of the index finger (left or right), then it is affected 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- diseases of the kidneys and lower back, 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 the right hand, then the lungs or large intestine. This is true for men, and 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 the left kidney or genitals may be affected. If on the right hand, then the right kidney or bladder.

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

Try to learn to distinguish between the strength of the pulsations with a superficial touch (surface pulse) and with strong pressure with the upper edges of the fingers (deep pulse).

If, with a superficial touch (surface pulse), a strong pulsation is felt with the index finger of the right wrist, then the problem is in the large intestine. If in the same position with strong pressure (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, located on the right wrist, may indicate the condition of the gallbladder (with a superficial touch, i.e. superficial pulse) and liver (with strong pressure, i.e. deep pulse).

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

A strong pulsation under the index finger, located 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, located on the left wrist, may indicate the condition of the stomach (with a superficial touch) and the spleen (with strong pressure).

A 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).

We'll give you some more tips that might help you. In diseases of heat, according to Tibetan traditional medicine, the 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 the middle finger. This area is responsible for the liver and gallbladder. Which of these organs is affected? If you feel unwell and have a fever, then the liver is affected. And if you began to freeze, then the gallbladder is to blame.

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

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

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

Literature:
Yeshe Donden. Health through balance. M.: LLP “WAY TO YOURSELF”, 1996, 192 p.
Ayurveda: Guide to practical methods. /Under the total. ed. IN AND. Borodkin. - Minsk: "Vida-N", 2000, 320 p.
Atlas Tibetan medicine. A set of illustrations for a Tibetan medical treatise of the 17th century. Album. /Col. Auth. M.: Galart, 1994, 592 p.
"Chzhud-shi" - a monument of medieval Tibetan culture, Per. from Tib. Foreword D. B. Dashieva, S. M. Nikolaev, Novosibirsk: Science. Sib. Department, 1988, 349 p.

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

The pulse in symmetrical areas can be various(p.differences). Pathological processes (unilateral anomalies of the 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. There is a unilateral decrease in the filling of the pulse with a simultaneous delay of the pulse wave or without it.

Popov-Saveliev's symptom: pulse on the left arm of lesser filling (especially in the position on the left side) with mitral stenosis, since the hypertrophied left atrium compresses the left subclavian artery.

· The rhythm of the pulse.

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

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

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

Pulse uniform - pulse waves are equal to each other.

Violation of the regularity of the pulse - irregular pulse ( p.irregularis).

Pulse waves become different in magnitude - uneven pulse.

Some types of arrhythmias are relatively easy to catch on palpation. These include:

Respiratory arrhythmia - pulse at respiratory movements it speeds up (when you inhale), then slows down (when you exhale). It is characteristic that when holding the breath, this type of arrhythmia is eliminated;

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

Atrial fibrillation- the pulse is arrhythmic, its individual waves of various 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;

Atrioventricular blockade of the third degree - very rare (less than 40 beats per 1 minute), regular and not changing in 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). With an arrhythmic pulse, they count for at least 1 minute.

Normal heart rate is 60-90 per minute.

Normally, the pulse rate varies significantly depending on age, sex, height. In newborns, the pulse rate reaches 140 beats per 1 minute. The pulse rate is often the greater, the higher the patient.

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

Pulse frequent(p.frequens) - the pulse rate is more than 90 in 1 minute.

Pulse rare(р.rarus) - pulse rate less than 60 in 1 minute.

Frequent pulse occurs with physical and mental stress, with sinus tachycardia, heart failure, drop in blood pressure, anemia, thyrotoxicosis, seizure paroxysmal tachycardia, at painful sensations. With an increase in body temperature by 1ºC, the pulse rate increases by 8-10 beats per 1 minute.

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

· Pulse deficit.

Pulse deficit- the number of heartbeats and the number of pulse waves in the periphery may not match (with atrial fibrillation).

Pulse deficit is determined by palpation-auscultatory method in patients with arrhythmia.

There are two ways to determine the deficiency of the pulse.

First way. ABOUT at the same time, a stethoscope is placed on the apex of the heart to count the number of heartbeats, and the pulse on the radial artery is palpated with the other hand (Fig. 5.5.2).

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

The presence of a pulse deficit indicates a weakness in 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.

· The state of the vascular wall.

Definition state of elasticity of the vascular wall.

To determine the state of the wall of the radial artery, three fingers of the palpating hand (second, third, fourth) are placed on it. First, the artery is squeezed with the second finger until the backflow 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 vessel wall with sliding movements.

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

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

· Pulse filling.

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

To determine the filling of the pulse on the radial artery, three fingers of the palpating hand (second, third, fourth) are placed. First, the artery is squeezed 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 an 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 estimated by the degree of elevation of the third finger (Fig. 5.5.4.).

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

Full pulse (p. plenus) - the oscillation of the entire palpating finger is felt.

A full pulse occurs in athletes during sports, during physical exertion.

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

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

An empty pulse occurs with hypotension, acute cardiovascular vascular insufficiency(collapse, cardiogenic shock), stenosis of the aortic mouth.

· Pulse tension.

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

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

Solid pulse (p. durus) - preservation of the pulsation of the artery with strong compression of it.

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

Soft pulse (r. 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 value pulse is very difficult, and therefore about her indirectly judge based on the total assessment of the filling and tension of the pulse wave.

The value of the pulse is affected by pulse pressure and filling of the arteries.

The size is distinguished:

big pulse (r.magnus) - pulse of good filling and tension;

small pulse (r.parvus) - pulse of small filling and tension;

filiform pulse (r.filiformis) - a barely palpable small and soft pulse.

big pulse occurs when the work of the heart is increased (insufficiency aortic valve thyrotoxicosis, fever). Under 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 with a decrease in the stroke volume of the left ventricle, a decrease in pulse pressure. It can occur when there is an obstruction between the heart and peripheral arteries - aortic stenosis or aneurysm.

A thready pulse occurs when big blood loss, acute vascular insufficiency (collapse), acute heart failure (cardiogenic shock).

· Pulse shape.

Form the pulse is determined by the sphygmogram, depends on the rate and rhythm of the rise and fall of the pulse wave.

The shape distinguishes the pulse:

Ambulance (р.celer),

Slow (p. tardus),

Dicrotic (p. dycroticus).

ambulance pulse - jumping, rapidly increasing, may be the result of an 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 (stenosis of the aortic mouth, mitral stenosis).

dicrotic The pulse is made up of two systolic peaks: the main pulse wave is followed by a new, as it were, second (dicrotic) wave of lesser strength, they correspond to only one heart contraction. The second wave of the pulse is caused by the reflection of blood in peripheral departments 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 there is a slowdown and acceleration of the outflow of blood from the veins into right atrium(respectively, swelling and collapse of the veins).

The venous pulse is detected and evaluated by inspection, palpation and phlebography.

The study of the venous pulse is carried out on the veins of the neck, necessarily at the same time examining the pulse on the carotid artery.

Normally, there is a subtle and almost imperceptible pulsation with the fingers.

right atrial, or negative venous pulse normal swelling jugular vein precedes the pulse wave on the carotid artery.

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

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

capillary pulse

Under capillary pulse understand 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).

It is possible to detect a change in the color of a 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).

By origin, the true and precapillary pulses are distinguished.

Cause true capillary pulse - varying degrees filling of the veins in the phase of systole and diastole of the heart, in connection with which the arterial knee of the capillaries pulsates rhythmically. Appears on faces young age with thyrotoxicosis, high temperature, after application of thermal procedures.

Precapillary pulse (Quincke pulse) occurs only in patients with aortic valve insufficiency. It is caused by the release into the systole phase a large number blood into the aorta and the transmission of pulse oscillations to the arterioles, and not to the capillaries. It is combined with the pulsation of large arteries ("pulsating man").