The heart rate or pulse is the number of times your heart beats during one minute.
In a healthy body, the pulse decreases during periods of rest and increases during physical activity, because during exercise the body needs stronger oxygenation.
When the pulse goes higher this puts increased pressure on the heart and other vital organs such as the lungs.
It is imperative to know if our heart rate is within normal limits, and if it falls outside the normal range, we must identify the cause and possibly follow a therapeutic strategy recommended by a cardiologist.
How is the heart rate measured?
Heart rate can be measured in several parts of the body: wrist, side of the neck, groin area and even the upper leg.
The traditional method
To measure the heart rate the traditional way, you have to press your finger on one of the abovementioned areas and count how many beats there are in 60 seconds.
Some cardiologists insist on a 10-minute rest period before measuring the heart rate in order to have an accurate value.
For adults over the age of 18, the measured heart rate at rest is between 60-100 beats per minute. People with a good fitness level and athletes can have a pulse as low as 40 bpm
Heart rate monitoring using an ECG
The ECG is a painless and non-invasive test, with the help of which every electrical signal of the heart (ie: every beat) can be observed.
The hearts’ activity is then rendered in the form of graphs that represent how the heart reacts to electromagnetic impulses.
Normal heart rate values according to age
The normal range for heart rate values varies depending on age.
Normal heart rate in children
Children normally have a higher pulse than adults. For example, in the case of a child aged 6-15, the pulse has normal values if it is anywhere between 70-100 beats per minute.
- newborn: between 100-170 beats per minute;
- baby (6 months-2 years): 90-130 beats per minute;
- children aged 2-4 years: 80-120 beats per minute;
- children aged 4-6 years: 70-110 beats per minute;
- children over 10 years: 60-100 beats per minute.
Normal heart rate in adults
Higher limit heart rate value
Physical exertion means that the heart reaches its maximum frequency of beats. In the case of an adult (male) who does sports, the pulse can reach up to 190 beats per minute. For physical activity, this heart rate is normal.
A normal resting heart rate should be under 100 beats per minute.
Lower limit pulse value
Likewise, a pulse of 50 beats per minute in a sleeping adult is not alarming. If the same average adult is active at 50 beats per minute this can signal a heart problem such as bradycardia.
Normal heart rate in the elderly
In the case of seniors, the normal heart rate is considered the following
- 60-65 years between 80-136 beats per minute. The maximum heart rate is 160 beats per minute.
- 65-70 years: between 78-132 beats per minute. The maximum heart rate is 155 beats per minute.
- Over 70 years: between 75-128 beats per minute. The maximum heart rate is 150 beats per minute.
Important note: If the pulse goes below 40 and the person feels dizzy or faints, this might indicate they may need a heart massage. This is a medical emergency so please make sure to contact the emergency services and closely follow their indications.
Heart rhythm disorders
General symptoms of heart rhythm disorders are the following:
- Weakness
- Dizziness
- Irregular pulse
- Heart palpitations
- Difficulty breathing
- Chest pain or stinging in the heart area
- Pallor
- Profuse sweating
Here are the most common heart rhythm disorders:
Bradycardia
Bradycardia means slow heartbeats -less than 60 beats per minute.
A heart rate lower than 60 beats per minute is considered normal for young athletes and poses no danger for them unless the heart rate drops below 40.
Causes
Bradycardia is caused by conditions that interrupt the formation of normal electrical impulses such as coronary heart disease, endocarditis, myocarditis etc.
Symptoms of bradycardia
- Dizziness
- Dyspnoea
- Chest pain
- Concentration problems
- Fatigue
- Lipothymia
Treatment
If the low heart rate is caused by an underlying condition, treating the cause might correct it.
Other treatment options include medication, lifestyle changes or even getting a pacemaker.
Tachycardia
Tachycardia involves an accelerated heartbeat at rest of over 100 beats per minute.
Causes
There are several factors that might trigger tachycardia:
- Underlying heart condition
- Congenital heart malformation
- Strong stress
- Anaemia
- Excessive alcohol consumption
- Consumption of energy drinks
- Smoking
- High levels of caffeine
- Hyperthyroidism
- Use of illegal drugs
- Hypertension
Symptoms of tachycardia
- Dizziness
- Fainting (syncope)
- Shortness of breath
- Chest pain
- Palpitations
- Lightheadedness
Treatment
Left untreated or treated too late tachycardia can lead to heart failure, heart attack, stroke, and cardio-respiratory arrest.
Treatment of tachycardia involves taking the required steps to lower a currently high heart rate and prevent future episodes by implementing the required lifestyle changes, using prescribed medication, implanted devices or specific procedures (cardioversion, catheter ablation etc).
Cardiac arrhythmia
Cardiac arrhythmia is the medical term used for irregular heartbeats, or for an abnormal heart rhythm.
Causes
Cardiac arrhythmias might have multiple causes:
- Ischemic heart disease
- Hypertension
- Cardiac surgery
- Electrolyte imbalances
- Viral illnesses
- Consumption of tobacco, alcohol or caffeine
- Heart failure
- Heart attack etc
Symptoms
While some arrhythmias have no symptoms, others have some noticeable ones:
- Palpitations
- Dizziness
- extreme fatigue
- Fainting
- Sweating
- Trouble breathing
Treatment
Cardiac arrhythmia treatment may include medications, implanted devices, catheter ablation and a variety of procedures and even surgery to control or eliminate irregular heartbeats, in conjunction with leading a healthy, heart-friendly lifestyle.
Heart rhythm disorders diagnosis
In the case of heart rhythm disorders, the cardiologist performs a physical examination, listens to the heart with a stethoscope and finds out what the patient’s symptoms are. There are several methods that might be used to confirm a diagnosis:
An electrocardiogram (ECG): is an investigation that shows in a graph the electrical impulses of the heart
Cardiac ultrasound: helps identify areas of the heart that are not working properly and might detect malformations and possible problems with the heart muscle
EKG Holter: is a portable device that monitors the patient’s heart for 24 hours (or more). Thus, arrhythmias that cannot normally be caught on an electrocardiogram can be detected;
Stress/effort test: this is an investigation during which the activity of the heart is evaluated, in conditions of intense physical effort (running on the treadmill or riding a bicycle)
MRI / computed tomography: imaging tests that help the doctor see the heart and heart circulation in detail
Coronary angiography: the doctor inserts a contrast substance into the arteries with a catheter and thus sees any blockages or abnormalities of the blood vessels.
How can we maintain a normal heart rate?
As previously mentioned, the heart rate can be influenced by a number of factors, from smoking, high blood pressure, high cholesterol, sedentary lifestyle, and obesity, to genetic factors, sex (men are more likely to develop cardiovascular disease at a younger age), age (the older a person is the more prone to develop cardiovascular issues).
While we can’t change our genetics, there are other important areas where we’re in control:
A proactive approach to preventing heart issues:
Make sure you don’t miss the regular laboratory tests – once a year unless your doctor recommends otherwise.
It is essential to monitor cholesterol, triglycerides and blood sugar and make sure these are within normal limits.
Blood pressure should be monitored, especially in people over 45 years of age. Normal blood pressure in adults should not exceed 120/80 mmHg.
Make sure you are aware of the potential risks associated with the use of OTC or prescribed drugs, including oral contraceptives, decongestants, asthma medicine etc.
Lifestyle changes for the health of your heart
Quit smoking
Smoking directly influences the chances of a heart attack, developing obesity, high blood sugar, high cholesterol and increasing the chances of lung cancers among other negative effects.
Chose a balanced diet and avoid overeating and excessive weight gain
Try to keep your BMI under 25-30. Any additional increase translates into a greater risk of heart disease. Opt for a healthy, fibre-rich diet to reduce LDL levels.
Keep stress under control
Learn how to unwind in a healthy way ( take a walk, do some light exercise or yoga, read a book or take up a new hobby) and don’t fail to treat any mental health issues as these can greatly impact your heart health as well.