What is an Apical Pulse and How Does It Reveal Your Heart Health?

You probably know how to check your pulse at your wrist or on the side of your neck. Did you know doctors can listen directly to your heart using a stethoscope to get the exact heartbeat? This special check is called an apical pulse. It gives you and your doctor a very clear picture of how well your heart works.

Checking your apical pulse helps medical professionals spot irregular rhythms, weak beats, and other heart concerns early. This guide will walk you through everything you need to know about your apical pulse in simple, plain English.

What is an Apical Pulse?

Put simply, your apical pulse is the most accurate way to check your true heart rate. Doctors also call this the point of maximal impulse or the apex beat. When you check your pulse at your wrist or neck, you feel pressure waves moving through your blood vessels. Those are called peripheral pulses.

Your apical pulse is completely different because it is not a pulse in a blood vessel. Instead, you feel or hear your lower left heart chamber, called the left ventricle, squeezing. Every single time your heart beats, this left ventricle pushes blood out through your main artery to your entire body. Listening directly to this movement gives your doctor precise details about your heart health.

Where is the Apical Pulse Located?

Your apical pulse is located near the pointy bottom tip of your heart. This bottom tip points down toward your left side. In rare cases, a person's heart points toward the right side. Doctors call this condition dextrocardia. For someone with dextrocardia, the apical pulse is found on the right side of the chest.

Where is the Apical Pulse Located in Adults?

In most healthy adults, you find the apical pulse on the left side of the chest. It sits right where your fifth and sixth ribs meet. Doctors call the space between your ribs an intercostal space. Therefore, the adult apical pulse is usually found in the fifth intercostal space.

Where is the Apical Pulse Located in Children?

The location changes for young children. In children under seven years old, the heart sits a bit higher in the chest. Their apical pulse is usually found between the fourth and fifth ribs. Doctors look for it in the fourth intercostal space for these young patients.

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Why Do Doctors Measure the Apical Pulse?

Your doctor gains valuable information by measuring your apical pulse. Modern digital devices can show your pulse quickly. However, those screens do not show your heart rhythm or pulse strength clearly. An apical pulse check gives all this important detail using only a simple stethoscope.

Your doctor might measure your apical pulse for several reasons:

• To check your overall health and wellness during routine physical exams.
• To monitor your heart health before and after certain medical treatments or surgeries.
• To gather baseline numbers that doctors can compare against future checks.
• To check how your heart responds to specific heart medicines like digoxin.

How Do Doctors Measure the Apical Pulse?

Your doctor uses a stethoscope to measure your apical pulse. They place the stethoscope directly on your bare skin. They will make sure you feel comfortable and keep you covered with a sheet or blanket to protect your privacy.

During the exam, your doctor usually follows these simple steps:

• They will ask you to lie flat on your back or turn slightly onto your left side. This brings your heart closer to your chest wall.
• They use their fingers to find the exact spot between your ribs where the pulse beats strongest.
• They place the flat end of the stethoscope, called the diaphragm or bell, onto that spot.
• They listen carefully for a full 60 seconds without speaking. This long listen ensures they count every single heartbeat accurately.
• They gently remove the stethoscope when finished.

Sometimes your doctor needs to check your pulse in more than one place at the same time. This special check is called an apical-radial pulse.

What is an Apical-Radial Pulse?

An apical-radial pulse happens when two healthcare workers check your pulse at the exact same time. One person listens to your apical pulse with a stethoscope. At the exact same second, another person feels your wrist pulse, called the radial pulse.

Ideally, your apical pulse number and your wrist pulse number match completely. However, if your heart is weak or you have a blood vessel disease, your wrist pulse might feel lower than your apical pulse. The difference between these two numbers is called a pulse deficit. Finding a pulse deficit helps your doctor diagnose specific heart rhythm disorders.

What is the Normal Apical Pulse Range?

For most healthy adults, the normal resting apical pulse ranges between 60 and 100 beats per minute. This is the ideal range when you rest quietly. Several everyday things can make your pulse go higher:

• Doing physical exercise or heavy work.
• Drinking caffeine found in coffee, tea, or soda.
• Feeling stressed, nervous, or very anxious.

As you grow older, your resting heart rate often slows down naturally. Certain medicines and health conditions also change your heart rate. Talk to your doctor to find out what resting pulse range is healthy for you.

Children naturally have faster heart rates than adults. Their normal range changes as they grow:

What Can an Apical Pulse Reveal About Your Health?

Measuring your apical pulse reveals many important health clues. Doctors do not just hear your heart speed up or slow down. They also listen closely to three key details:

• The strength of every single heartbeat.
• How long each heartbeat lasts.
• The overall rhythm of your heart sounds.

Listening to these details helps your doctor spot several medical conditions:

• Arrhythmias: Irregular heart rhythms, such as atrial fibrillation, where the heart beats too fast, too slow, or unevenly.
• Heart Valve Disease: Problems with your heart valves leaking, known as regurgitation, or narrowing, known as stenosis.
• Hypertrophic Cardiomyopathy: A condition where your heart muscle becomes abnormally thick.
• Dilated Cardiomyopathy: A condition where your heart chambers become enlarged and weak.

Can Finding the Apical Pulse Ever Be Difficult?

Yes, sometimes a doctor finds it hard to hear or feel your apical pulse. Certain physical factors can muffle the sound:

• Severe obesity or excess body weight.
• Chronic lung diseases that trap air in the chest.
• Fluid buildup around the heart, known as pericardial effusion.
• Fluid buildup around the left lung, known as left pleural effusion.

If this happens, your doctor will check your pulse in other spots. They may also order other heart tests. There is no need to worry if they need extra tests to get a clear view.

Final Thoughts to Remember.

Even though modern medicine relies on advanced digital technology, checking pulses by hand and stethoscope remains a vital part of healthcare. Your apical pulse is a crucial vital sign that helps doctors understand your heart health. Your doctor will likely check this pulse during routine checkups. If you stay in the hospital, your care team may check it regularly.

Feel free to talk with your doctor about your apical pulse and what it says about your heart health. This routine test is simple, fast, and gives your medical team great insight into how well your heart pumps every single day.