Manual measurement Wrist<unk>  monitor<unk>  monitor with a wrist receiver<unk>  is measured by finding the pulse of the heart. This pulse<unk>  can be found at any point on the body where the artery's pulsation is transmitted to the surface by pressuring it with the index and middle fingers; often it is compressed against an underlying structure like bone. The thumb should not be used for measuring another person's<unk> , as its strong pulse may interfere with the correct perception of the target pulse. The radial artery is the easiest to use to check the<unk> . However, in emergency situations the most reliable arteries to measure<unk>  are carotid arteries. This is important mainly in patients with atrial fibrillation, in whom heart beats are irregular and stroke volume is largely different from one beat to another. In those beats following a shorter diastolic interval left ventricle does not fill properly, stroke volume is lower and pulse wave is not strong enough to be detected by palpation on a distal artery like the radial artery. It can be detected, however, by doppler. Possible points for measuring the<unk>  are: # The ventral aspect of the wrist on the side of the thumb (radial artery). # The ulnar artery. # The inside of the elbow, or under the biceps muscle (brachial artery). # The groin (femoral artery). # Behind the medial malleolus on the feet (posterior tibial artery). # Middle of dorsum of the foot (dorsalis pedis). # Behind the knee (popliteal artery). # Over the abdomen (abdominal aorta). # The chest (apex of the heart), which can be felt with one's hand or fingers. It is also possible to auscultate the heart using a stethoscope. # In the neck, lateral of the larynx (carotid artery) # The temple (superficial temporal artery). # The lateral edge of the mandible (facial artery). # The side of the head near the ear (posterior auricular artery). ECG-RRinterval Electronic measurement In obstetrics,<unk>  can be measured by ultrasonography, such as in this embryo (at bottom left in the sac) of 6 weeks with a<unk>  of approximately 90 per minute. A more precise method of determining<unk>  involves the use of an electrocardiograph, or ECG (also abbreviated EKG). An ECG generates a pattern based on electrical activity of the heart, which closely follows heart function. Continuous ECG monitoring is routinely done in many clinical settings, especially in critical care medicine. On the ECG, instantaneous<unk>  is calculated using the R wave-to-R wave (RR) interval and multiplying/dividing in order to derive<unk>  in heartbeats/min. Multiple methods exist: *<unk>  = 1000*60/(RR interval in milliseconds) *<unk>  = 60/(RR interval in seconds) *<unk>  = 300/number of "large" squares between successive R waves. *<unk> = 1,500 number of large blocks<unk>  monitors allow measurements to be taken continuously and can be used during exercise when manual measurement would be difficult or impossible (such as when the hands are being used). Various commercial<unk>  monitors are also available. Some monitors, used during sport, consist of a chest strap with electrodes. The signal is transmitted to a wrist receiver for display. Alternative methods of measurement include seismocardiography. Optical measurements Pulsatile retinal blood flow in the optic nerve head region revealed by laser Doppler imaging Pulse oximetry of the finger and laser Doppler imaging of the eye fundus are often used in the clinics. Those techniques can assess the<unk>  by measuring the delay between pulses. Tachycardia Tachycardia is a resting<unk>  more than 100 beats per minute. This number can vary as smaller people and children have faster<unk> s than average adults. Physiological conditions where tachycardia occurs: # Pregnancy # Emotional conditions such as anxiety or stress. # Exercise Pathological conditions where tachycardia occurs: # Sepsis # Fever # Anemia # Hypoxia # Hyperthyroidism # Hypersecretion of catecholamines # Cardiomyopathy # Valvular heart diseases # Acute Radiation Syndrome Bradycardia Bradycardia was defined as a<unk>  less than 60 beats per minute when textbooks asserted that the normal range for<unk> s was 60–100 bpm. The normal range has since been revised in textbooks to 50–90 bpm for a human at total rest. Setting a lower threshold for bradycardia prevents misclassification of fit individuals as having a pathologic<unk> . The normal<unk>  number can vary as children and adolescents tend to have faster<unk> s than average adults. Bradycardia may be associated with medical conditions such as hypothyroidism. Trained athletes tend to have slow resting<unk> s, and resting bradycardia in athletes should not be considered abnormal if the individual has no symptoms associated with it. For example, Miguel Indurain, a Spanish cyclist and five time Tour de France winner, had a resting<unk>  of 28 beats per minute, one of the lowest ever recorded in a healthy human. Daniel Green achieved the world record for the slowest heartbeat in a healthy human with a<unk>  of just 26 bpm in 2014. Arrhythmia Arrhythmias are abnormalities of the<unk>  and rhythm (sometimes felt as palpitations). They can be divided into two broad categories: fast and slow<unk> s. Some cause few or minimal symptoms. Others produce more serious symptoms of lightheadedness, dizziness and fainting. Correlation with cardiovascular mortality risk A number of investigations indicate that faster resting<unk>  has emerged as a new risk factor for mortality in homeothermic mammals, particularly cardiovascular mortality in human beings. Faster<unk>  may accompany increased production of inflammation molecules and increased production of reactive oxygen species in cardiovascular system, in addition to increased mechanical stress to the heart. There is a correlation between increased resting<unk>  and cardiovascular risk. This is not seen to be "using an allotment of heart beats" but rather an increased risk to the system from the increased<unk> . An Australian-led international study of patients with cardiovascular disease has shown that heart beat<unk>  is a key indicator for the risk of heart attack. The study, published in The Lancet (September 2008) studied 11,000 people, across 33 countries, who were being treated for heart problems. Those patients whose<unk>  was above 70 beats per minute had significantly higher incidence of heart attacks, hospital admissions and the need for surgery. Higher<unk>  is thought to be correlated with an increase in heart attack and about a 46 percent increase in hospitalizations for non-fatal or fatal heart attack. Other studies have shown that a high resting<unk>  is associated with an increase in cardiovascular and all-cause mortality in the general population and in patients with chronic diseases. A faster resting<unk>  is associated with shorter life expectancy and is considered a strong risk factor for heart disease and heart failure, independent of level of physical fitness. Specifically, a resting<unk>  above 65 beats per minute has been shown to have a strong independent effect on premature mortality; every 10 beats per minute increase in resting<unk>  has been shown to be associated with a 10–20% increase in risk of death. In one study, men with no evidence of heart disease and a resting<unk>  of more than 90 beats per minute had a five times higher risk of sudden cardiac death. Similarly, another study found that men with resting<unk> s of over 90 beats per minute had an almost two-fold increase in risk for cardiovascular disease mortality; in women it was associated with a three-fold increase. Given these data,<unk>  should be considered in the assessment of cardiovascular risk, even in apparently healthy individuals.<unk>  has many advantages as a clinical parameter: It is inexpensive and quick to measure and is easily understandable. Although the accepted limits of<unk>  are between 60 and 100 beats per minute, this was based for convenience on the scale of the squares on electrocardiogram paper; a better definition of normal sinus<unk>  may be between 50 and 90 beats per minute. Standard textbooks of physiology and medicine mention that<unk>  <unk>  is readily calculated from the ECG as follows:<unk>  = 1000*60/RR interval in milliseconds,<unk>  = 60/RR interval in seconds, or<unk>  = 300/number of large squares between successive R waves. In each case, the authors are actually referring to instantaneous<unk> , which is the number of times the heart would beat if successive RR intervals were constant. Lifestyle and pharmacological regimens may be beneficial to those with high resting<unk> s. Exercise is one possible measure to take when an individual's<unk>  is higher than 80 beats per minute. Diet has also been found to be beneficial in lowering resting<unk> : In studies of resting<unk>  and risk of death and cardiac complications on patients with type 2 diabetes, legumes were found to lower resting<unk> . This is thought to occur because in addition to the direct beneficial effects of legumes,
Heart rate
Respiratory rate
Blood pressure
Heart sounds
Cardiac output
Pulse
Pulse 
Muscle tone