Heart rate

“ While any pulse rate below 50 should be considered abnormal and more or less pathologic, still a pulse rate no lower than 60 may, be very abnormal for the individual. For athletes and those who work hard physically, a slow pulse is normal. Such hearts are often not even normally stimulated by high fever, so that the pulse is unusually slow, considering the patient's temperature, unless inflammation of the heart has occurred. ”

“ There is no doubt, however, that anxiety about the heart will quicken or slow the pulse rate. When a patient comes to be examined for suspected heart trouble the pulse rate is almost sure to be higher than normal, even though there may be nothing the matter with the heart; the increase or decrease of the pulse beat is due to the anxiety lest some heart lesion should be discovered. ”

“ Regular exercise increasing the heart rate to 140/m for a 10-15 minutes reduces the resting heart rate. A trained long distance runner may have a resting heart rate of 40-50 beats per minute. The recovery phase is faster in trained athlete. As the result of training the heart increases in size because of heart muscle hypertrophy. ”

“ With a sound heart the blood pressure will be higher and the pulse slower than the previous record taken. If the blood pressure and pulse beat are not changed, it shows that the heart is not quite normal, but not actually incompetent. When the blood pressure is lower and the pulse accelerated, he believes that there is distinct functional disturbance of the heart and loss of power, relatively to the change in pressure and the increase of the pulse rate. He further believes that a heart showing this kind of weakness should, if possible, not be subjected to general anesthesia. ”

“ The warning symptom in heart disease that the patient is giving out is the development of irregularity and rapidity of the pulse. On the other hand, when a pulse has been running rapidly for weeks and then drops to below the regular rate, to 50 or 60, a fatal termination may be looked for at almost any time, though, of course, the patient may rally. The prognosis of heart cases is extremely difficult. ”

“ In patients with cardiac insufficiency he finds there is a delayed rise in the systolic pressure after even slight exercise, and those with marked cardiac insufficiency have even a lowering of blood pressure from the ordinary level. They all have increase in pulse rate. He quotes several authorities as showing that during muscle work the carbon dioxid of the blood is increased in amount, which, stimulating the nervous centers controlling the suprarenal glands, increases the epinephrin content of the blood. ”

“ Every man should familiarize himself with certain physiological facts, and with these as guideposts he ought to be able to follow a train of indications to a reasonably fair diagnosis. The pulse rate, taken at the wrist, is generally a fair index of the condition of the body. The normal man has a pulse rate of about seventy-two beats per minute, women somewhat more rapid; high elevations also produce a more rapid pulse.
If there is an increase of heart beat above56 eighty per minute, accompanied by other subjective symptoms, it is an indication that something is wrong. ”

“ He does not believe that the estimate of the pressure pulse is indicative of cardiac strength. He believes that the important factors in the estimation of the circulatory strength are the systolic pressure, which shows the power of the left ventricle, the diastolic pressure, which shows the intravascular tension during diastole as well as the peripheral resistance, and the pulse rate, which designates the number of times the heart must contract during a minute to maintain the proper flow of blood. ”

“ This load of the heart is also shown by an increased pulse rate and increased respiratory efforts. In cardiac failure, as the systolic pressure falls the diastolic is likely to be increased, and the pressure pulse thus diminishing, allows insufficient blood to go to the medullary centers, and death soon occurs. ”

“ The pulse is beating at the rate of about 72 per minute or say once in a second. The frequency of the beat is not always constant but fluctuates under excitation or depression.
The normal blood-pressure and its induced changes can also be recorded by elaborate contrivances. The record thrown on the screen shows the change in the blood pressure by alternate stimulation and partial inhibition of the activity of the heart-pump. Under normal conditions the up and down-strokes of each constituent pulse are equal. During increasing
Record of falling and rising blood pressure. ”

“ The most striking symptom of heart affection, indeed the only positive physical sign, is the great increase in the frequency of the heart’s action, the pulse rate often being as much as 150 or 160 per minute, and in addition weak and somewhat variable in strength. At the outset of the disease, no oedema of the lower extremities is to be observed, and it only appears after three or four attacks. In all the patients the extreme pallor of the face is a striking feature. An increased quantity of urine is eliminated. ”

“ Success with Coca's Pulse Test requires only motivation and a little perseverance, because in order to test for food allergies, the diet must be restricted for a few days and your pulse must be accurately taken at specific intervals during the testing period.
The test is based on measurement of the resting pulse rate, something most people have no difficulty learning how to do. The resting rate is how fast the heart beats after a person has been sitting still, comfortably relaxing for three to five minutes. When a person is active the heart beats faster than the resting rate. ”

“ One feature of the heart action with which we are all perfectly familiar is that both the rate and the vigor of the heartbeat vary greatly from time to time. When one is lying quietly, the heartbeat is at its lowest point. It becomes more rapid as one sits up, still more rapid upon standing, increasing still more with the taking of any form of muscular exercise, and in vigorous muscular exercise attains its greatest rapidity and force. ”

“ It should be remembered that athletes have slow pulse, and the severity of their condition must not be interpreted by the rate of the pulse. Even with high fever the pulse of an athlete may be slow.
Not enough investigations have been made of the rate of the pulse during sleep under various conditions. ”

“ With age the arterial walls grow stiffer and more rigid and less adapted to their work. In certain cases of heart disease the heart does not transmit all the beats to the pulse and to get the true rate the heart must be listened to. ”

“ The call of an actively functionating organ or group of organs causes a widening of a more or less extensive area, and the velocity necessarily varies. In states of great relaxation of the vessels there may be a capillary pulse. In order to force blood at the same rate through dilated vessels as through normal vessels, there must be more blood or there must be a more rapid contraction of the central pump. What actually happens, as a rule, is an increase in the rate of the heart beat. ”

“ Daily aerobic exercise will strengthen the heart, gradually slowing the heart's resting pulse rate, indicating that the heart has become much stronger, pumping more blood with each pulse. As the resting pulse drops the exercising heartbeat can be increased to double the resting rate. ”

“ Thus it has been calculated that, assuming the heart to beat sixty-nine times a minute at ordinary heart pressure, the blood goes at the rate of two hundred and seven yards in the minute, or seven miles per hour, one hundred and sixty-eight miles per day and six thousand three hundred and twenty miles per year. If a man of eighty-four years of age could have one single blood corpuscle floating in his blood all his life it would have traveled in that same time five million one hundred and fifty thousand eight hundred and eight miles. ”

“ There are thereafter certain minor fluctuations in the rate of the heart-beat with advancing age, but generally it may be said that this value of 72 beats a minute is characteristic of adult life. But when a person becomes eighty years old, it has been found that upon the average the rate of the heart-beat rises and becomes 79 a minute. Hence it is clear that though the heart is larger, it has to make a greater effort, that is to say a more frequent beat, in order to maintain the necessary circulation of the blood. ”

“ There may be a ratio of auricular contractions to ventricular contractions, according to Fulton, of 2:1, 3:1, 4:1 and 5:1, the 2:1 ratio being most common.
Of course it is generally understood that children have a higher pulse rate than adults; that women normally have a higher pulse rate than men at the same age; that strenuous muscular exercise, frequently repeated, without cardiac tire while causing the pulse to be rapid at the time, slows the pulse during the interim of such exercise and may gradually cause a more or less permanent slow pulse. ”

“ Activity of the Heart.—The average number of heart-beats during a lifetime may be considered as at the rate of seventy-two per minute, although this estimate is probably low; for during several years of early life the rate is above one hundred a minute. ”

“ A healthy heart beats from 120 times per minute in a one-year-old infant to 60 per minute in a very aged person. The normal rate for a middle-aged adult is from 80 to 70 beats.
Heart disease signifies the failure of the heart valves to close properly. Blood passes back when the heart contracts, and the circulation is much enfeebled. By listening through a stethoscope the doctor is able to tell whether the valves are in good order. A hissing sound during the beat indicates a leakage past the valves ”

“ But the power of the heart becomes inferior along with this hypertrophy or enlargement, and we see that in the old, in order to make up for the feebleness of the enlarged heart, it beats more frequently. In other words, the pulse rate in the old person increases. ”

“ It always takes more time for the blood to reach the head on a fast because everything has slowed down, including the rate of the heart beat, so blood pressure probably has dropped as well. If you stand up very quickly you may faint. I repetitively instruct all of my clients to stand up very slowly, moving from a lying to a sitting position, pausing there for ten or twenty seconds, and then rising slowly from a sitting to a standing position. ”

“ Its inherent rate of rhythmicity is probably more rapid than the usual numbers of impulses per minute, but it is inhibited by the vagus. Paralysis of the vagus endings increases the rate of impulse formation and therefore the rate of the heart. ”

“ Usually the pulse beats four times during one respiration, but both in health and disease its frequency may be accelerated or retarded. In adults, there are from sixty-five to seventy-five beats in a minute, and yet in a few instances we have found, in health, only forty pulsations per minute. But when the heart beats from one hundred and twenty to one hundred and forty times a minute, there is reason to apprehend danger, and the case should receive the careful attention of a physician.
Irregularity of the pulse may be caused by disease of the brain, heart, stomach, or liver ”

“ We should all expect the cardio-vascular system to undergo important changes with increasing age; but few of us would be prepared to find that these changes are neither uniformly progressive nor indeed continuously progressive in the same direction. To make more easily intelligible the nature and as far as possible the origin of these anatomical alterations in the heart and arteries during the second half of life, I will first refer for a moment to the circulation from 20 to 45. During this period of life the blood-pressure is relatively high, reaching its maximum about 36 ”

“ Some chronic diseases cause a slow pulse; this is especially true of chronic interstitial nephritis. In fact, it may be stated that any disease or condition which increases the blood pressure generally slows the pulse, unless the heart itself is affected. This is true of hypertension, of arteriosclerosis, of nicotin unless the heart has become injured, and often of caffein, unless it acts in the individual as a nervous stimulant. Chronic lead poisoning causes a slow pulse on account of the increased blood pressure. ”

“ I am anxious to direct your attention, if it be but for a moment, to the fact that in many instances where præcordial oppression, pain, palpitation and faintness, with frequent small irregular pulse, are significant of serious disturbance of the action of the heart, there is no failure of the myocardium in the proper sense of the term, but only embarrassment of a temporary character. ”

“ A force which is sufficient to send blood through elastic normal distributing tubes becomes totally insufficient to send the same amount of blood through tortuous and more or less inelastic tubes. As a compensatory process the pulse pressure increases. For this to increase, the left ventricular cavity dilates, the arch dilates, and as a greater force must be exerted to keep the increased mass in motion, the heart responds by hypertrophy of its left ventricle and becomes itself the subject of fibrous changes in the myocardium. ”

“ What method might be followed with advantage in making a complete diagnosis of heart disease in older subjects?
A man of 60 consults us about his heart. He says that it has caused him a good deal of concern lately. More specifically he describes a sense of oppression behind the sternum as often as he exerts himself, and palpitation with consciousness of irregular [32] cardiac action when he goes to bed. We inquire for other familiar cardiac symptoms, such as pain, angina, fluttering, faintness, giddiness, and a sense of impending death. ”