In cardiac disease pulse rate can be lesser than heart rate
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pulse deficit heart rate higher than pulse rate atrial fibrillation clinical examination
Yes. This is called a pulse deficit.
- Heart rate counts every ventricular contraction, usually heard at the apex or recorded on ECG.
- Pulse rate counts only contractions that generate a palpable peripheral arterial pulse, such as at the radial artery.
If a beat produces too little stroke volume, its pulse wave may not reach the wrist. Therefore:
Heart rate > pulse rate
It occurs especially with:
- Atrial fibrillation, particularly with a rapid ventricular rate
- Frequent premature beats, especially early ectopic beats
- Severe low-output states or marked hypotension
Example: apical heart rate = 120/min, radial pulse = 90/min.
Pulse deficit = 30/min.
Pulse deficit = 30/min.
The mechanism is reduced ventricular filling for some beats, causing a very small stroke volume that fails to create a palpable peripheral pulse. Clinical Methods describes this in atrial fibrillation. Guyton and Hall similarly explains that premature contractions can produce minimal ventricular filling and an absent peripheral pulse.
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