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Carotid palpation, coronary heart disease and exercise rehabilitation
Insights
Carotid palpation minimally affects heart rate in cardiac patients during rest and exercise. These small changes are generally too minor for accurate monitoring in typical exercise rehabilitation programs.
Area of Science:
- Cardiology
- Exercise Physiology
- Rehabilitation Medicine
Background:
- Heart rate monitoring is crucial for assessing exercise intensity in cardiac patients.
- Carotid artery massage is known to induce baroreceptor reflex effects on heart rate.
Purpose of the Study:
- To evaluate the impact of carotid palpation on heart rate in male cardiac patients.
- To determine the feasibility of using carotid palpation for heart rate monitoring in cardiac rehabilitation.
Main Methods:
- Sixty male cardiac patients (post-myocardial infarction, bypass surgery, or with angina) had their heart rate monitored.
- Heart rate was measured at rest, during exercise, and post-exercise, with and without carotid palpation.
Main Results:
- Carotid palpation resulted in small mean heart rate changes: -3.5 bpm at rest and -2.2 bpm during exercise in the testing group.
- The training group showed changes of +0.8 bpm at rest and -3.1 bpm post-exercise.
- These changes were generally too small for accurate monitoring using standard palpation counts (10-15 seconds).
Conclusions:
- Carotid palpation has a minimal, statistically significant effect on heart rate at rest in cardiac patients.
- Despite small changes, carotid palpation can be safely used in cardiac exercise rehabilitation if patients are properly instructed and technique is checked.
Abstract:
Heart rate, determined by palpation of the carotid, radial, or temporal artery, is commonly used to monitor exercise intensity. It is known that massage of the carotid artery has a baroreceptor reflex effect on the heart rate. The heart rate, monitored with and without carotid palpation, at rest, during exercise, and immediately post-exercise was determined in 60 male cardiac patients (39-65 years of age) following either myocardial infarction (n=52), bypass surgery (n=6), or those with angina pectoris (n=2). The mean changes in heart rate with carotid palpation in the testing group were -3.5 bpm at rest and -2.2 bpm during exercise; in the training group the changes were +0.8 bpm at rest -3.1 bpm post exercise. While the mean decrease at rest in the testing group was statistically significant, each of the decreases in resting, during, and post-exercise heart rates were too small to be accurately monitored by palpation over a 10- or 15-sec count, a usual procedure in exercise rehabilitation programs. Provided the patients are correctly instructed and technique regularly checked, there appears to be no reason why carotid palpation should not be used in cardiac exercise rehabilitation programs to determine resting, exercise, or post-exercise heart rates.