Why should I have my pulse checked?
Dr Mike Knapton says:
A doctor holding a patient’s wrist to take their pulse is a classic medical image. Now we understand that this simple examination could play a significant part in stroke prevention.
The pulse is usually taken from the radial artery, which can be felt at the wrist, where a watchstrap usually sits, in line with the base of the thumb. It should be felt with two or three fingers of the other hand.
A normal pulse will have a regular rate of about 70 beats per minute but can be lower or higher. An irregular pulse can be caused by a number of heart rhythm disturbances, but the most common is atrial fibrillation (AF).
Pulse check could play a significant part in stroke prevention
The heart has a natural pacemaker. This sends out a regular electrical impulse that causes the heart to contract, creating the pulse. When someone has AF, impulses fire off from different places in the atria (the two upper heart chambers), causing chaotic electrical activity, which means an irregular, and sometimes fast, pulse.
AF can cause symptoms such as shortness of breath or palpitations, but many people have no symptoms. However, because AF is estimated to increase your risk of stroke by five times, it’s important to know whether you have it, so you can reduce your risk.
This means it’s a good idea to check your pulse, or get your doctor or nurse to do it for you. You can have a pulse check as part of an NHS Health Check, which is available to all those over 40 who haven’t already been diagnosed with cardiovascular disease or another long-term health condition.
If you have an irregular pulse, the next step is to have an electrocardiogram (ECG) to confirm whether you have AF. Anticoagulation medication (either warfarin or a newer oral anticoagulant drug such as dabigatran, rivaroxaban or apixaban) can reduce the risk of having a stroke by thinning the blood and reducing the risk of blood clots.
Meet the expert
Dr Mike Knapton is Associate Medical Director (Prevention and Care) at the BHF, overseeing the strategic role in helping patients and the public reduce their risk of heart disease. He remains a GP and works one day a week at a practice in Cambridge.