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What is an Apical Pulse?

By Lucinda Reynolds
Updated: Mar 03, 2024

The human heart is not actually heart shaped — it has a shape that resembles a pear. The apical pulse is the heartbeat that is heard at the apex of the heart. The heart apex is located at the very bottom left of the organ.

A stethoscope is used to listen to the apical pulse. In most cases, the best way to get an accurate heart rate is to count the beats heard at the heart apex for one full minute. If the individual has a normal heart rate, the sound that is heard through the stethoscope will usually be a "lub-dub" sound.

There are several reasons why an this pulse is preferred over counting the heartbeat detectible in the wrist or the neck. Some individuals have irregular heart beats, but these irregularities are not always transmitted to the arteries in the extremities. Therefore, the pulse that is counted in the wrist can be different than the apical pulse.

Young children and infants should have their heart rate assessed by the apical pulse. It can be difficult to count the heart rate by feeling pulses in the arms or legs in infants because their heart rates are normally very fast. When assessing the heart rate of an infant, it is best to do it while the baby is calm since the heart will be very difficult to hear if the infant is crying.

The normal range for a heart rate in a healthy adult is 60 to 100 heartbeats per minute. Any deviation from this normal range could indicate a health problem that needs to be checked out. Infants will have the fastest heart rates, with a normal range between 70 and 170 beats per minute. The average heart rate for a healthy infant is 135 beats per minute.

When an individual takes certain heart medications, he is usually told to measure his the apical heart rate before taking it. One such medication is digoxin, which is used to regulate irregular heart beats or to slow fast heart rates. An pulse below 60 beats per minute should cause some concern for individuals on heart medications, and a healthcare professional should be notified.

Healthcare providers are trained to listen to the apical pulse. When a medical professional does a heart assessment on a patient, the rate, rhythm and the strength of the heart beats are noted. The results of these findings can sometimes be an indicator of an underlying illness or disease.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Discussion Comments
By Oceana — On Sep 26, 2011

I was on a high dose of blood pressure medication, and I had been feeling very tired and weak. I used a blood pressure machine that also checked my pulse, and both were very low.

I went to my doctor and told him about my situation. After checking my apical pulse, he decided that he should decrease the dosage of my medication.

After a few days, I started regaining strength. He had told me to come back in a week so the nurse could check my heart rate. She said it was normal, and I could tell a big difference.

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