Physical examination maneuver

Physical Exam

Heart Rate

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How to Perform

Palpate a peripheral pulse, commonly the radial artery, with the pads of two fingers and count the beats over a timed interval — 30 seconds doubled, or a full 60 seconds if the rhythm is irregular. Heart rate can be calculated with cardiac aulscultation when peripheral pulses are weak or the rhythm is irregular.

How to Interpret

Showing 15 of 31 findings

Atrial Fibrillation

Apex-radial pulse deficit
Rule in
Somewhat helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Moderate

Bacteremia

Tachycardia
Rule in
Minimally helpful
Rule out
Minimally helpful
Evidence:Strong

Decompensation

Pulse ≤81/min in a patient with acute severe aortic regurgitation from infective endocarditis
Rule in
Minimally helpfulDerived CI
Rule out
HelpfulDerived CI
Evidence:Moderate
Pulse ≥94/min in a patient with acute severe aortic regurgitation from infective endocarditis
Rule in
Somewhat helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Moderate

Hypothyroidism

Bradycardia (resting heart rate <60 bpm)
Rule in
Somewhat helpful
Rule out
Minimally helpfulDerived CI
Evidence:Moderate

Mortality

Admission heart rate <100/min in a hospitalized adult
Rule in
Somewhat helpfulDerived CI
Rule out
Not helpfulDerived CI
Evidence:Moderate
Admission heart rate ≥120/min in a hospitalized adult
Rule in
Somewhat helpfulDerived CI
Rule out
Not helpfulDerived CI
Evidence:Moderate
Admission heart rate 100-119/min in a hospitalized adult
Rule in
Somewhat helpfulDerived CI
Rule out
Not helpfulDerived CI
Evidence:Moderate

Pneumonia

Tachycardia (pulse rate >100 bpm)
Rule in
Somewhat helpful
Rule out
Not helpful
Evidence:Strong

Postoperative Complication

Heart rate >100/min after ventral hernia repair
Rule in
Somewhat helpful
Rule out
Somewhat helpfulDerived CI
Evidence:Moderate
Heart rate >85/min before lung cancer surgery
Rule in
Somewhat helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Moderate

Pulmonary Embolism

Tachycardia
Rule in
Not helpful
Rule out
Not helpful
Evidence:Strong

Serious Adverse Event

Tachycardia (heart rate ≥100 bpm) in a normotensive patient with acute pulmonary embolism
Rule in
Minimally helpfulDerived CI
Rule out
Minimally helpfulDerived CI
Evidence:Moderate

Typhoid Fever

Relative bradycardia
Rule in
Somewhat helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Moderate

Upper Gastrointestinal Bleeding

Heart rate >100/min
Rule in
Somewhat helpful
Rule out
Somewhat helpful
Evidence:Moderate

Related Bedside Tests

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Blood Pressure
Rule in:VHHypovolemia, VHMortality, VHStructural Brain Lesion +22 more
Rule out:VHCardiac Tamponade, VHHypovolemia, HLow Cardiac Output +22 more
Cardiac AuscultationMembers
Sign in
Cardiac Auscultation
Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy +37 more
Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy, VHRight-sided Valvular Lesion +37 more
Respiratory RateMembers
Sign in
Respiratory Rate
Rule in:HReduced Left Ventricular Ejection Fraction, SHCardiopulmonary Arrest, SHPneumonia +10 more
Rule out:MHCardiopulmonary Arrest, MHPulmonary Embolism, NHPneumonia +10 more
Carotid Artery PalpationMembers
Sign in
Carotid Artery Palpation
Rule in:HAortic Stenosis, HTakayasu Arteritis, IEAcute Aortic Dissection +9 more
Rule out:SHAortic Stenosis, NHTakayasu Arteritis, IEAcute Aortic Dissection +9 more
🎬Video coming soon
Jugular Venous Pressure
Rule in:VHShock, HRight Ventricular Infarction, SHElevated Pulmonary Capillary Wedge Pressure +14 more
Rule out:HRight Ventricular Infarction, SHElevated Pulmonary Capillary Wedge Pressure, SHPulmonary Hypertension +14 more
🎬Video coming soon
Lung Auscultation
Rule in:VHChronic Obstructive Pulmonary Disease, VHPneumothorax, HMainstem Bronchus Intubation +29 more
Rule out:VHChronic Obstructive Pulmonary Disease, HPleural Effusion, SHInterstitial Lung Disease +28 more

Related Systems / Regions

CardiovascularGeneral and Vital Signs

Related Diagnoses

AnemiaAtrial FibrillationBacteremiaCardiac TamponadeDecompensationDengue InfectionGallstone PancreatitisHyperthyroidismHypothyroidismIncreased Intracranial PressureInfective EndocarditisMajor TraumaMortalityMyocardial InfarctionPneumoniaPontine HemorrhagePostoperative ComplicationPulmonary EmbolismReduced Left Ventricular Ejection FractionSepsisSerious Adverse EventShockTyphoid FeverUpper Gastrointestinal Bleeding

Related Chief Complaints

AnxietyBlack StoolsChest DiscomfortChest PainChest PressureChillsCold ExtremitiesCold IntoleranceConfusionConstipationCoughCough Productive of SputumCoughing Up BloodDepressionDiarrheaDizzinessDouble VisionDrowsinessDry SkinExercise IntoleranceExertional DyspneaEye BulgingFacial SwellingFatigueFeverFrequent Bowel MovementsHair LossHeadacheHeat IntoleranceHeavy PeriodsHoarse VoiceInsomniaIrregular PeriodsLeg SwellingLightheadednessLow Blood PressureMemory ProblemsMuscle AchesNauseaNeck SwellingPain Worse with BreathingPallorPalpitationsPleuritic Chest PainPuffy FaceRapid BreathingShortness of BreathSlow Heart RateSweatingSyncopeTremorVision ChangesVomitingVomiting BloodWeaknessWeight GainWeight Loss

References

Research in progress on one or more findings above; ratings may change.

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  • Roy CL, Minor MA, Brookhart MA, Choudhry NK. Does this patient with a pericardial effusion have cardiac tamponade? JAMA. 2007;297(16):1810-1818. PMID 17456823.
  • West J, Goodacre S, Sampson F. The value of clinical features in the diagnosis of acute pulmonary embolism: systematic review and meta-analysis. QJM. 2007;100(12):763-769. doi:10.1093/qjmed/hcm113. PMID 18089542.
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  • Chasapi A, Mbonye KA, Bajomo O, et al. Clinical and echocardiographic predictors of decompensation in acute severe aortic regurgitation due to infective endocarditis. Echocardiography. 2021;38(4):590-595. PMID: 33711172.
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Research last updated September 10, 2026.