Dr.

EZE Ejike Daniel, PhD

DEPARTMENT OF PHYSIOLOGY

JANUARY, 2025
• Heart Rate
• How to count the heart rate
• Physiological variation of heart rate
• Control of the Heart Rate
Heart Rate
• In normal adult male under resting ordinary conditions, the heart beats at an
average rate of 75 beats/min.
• Values between 60 and 100 beats/min are accepted as normal.
• A heart rate higher than 100 beats/min is called tachycardia and a rate lower than
60 beats/min is called bradycardia.
• During severe muscular exercise the heart rate increases up to 200 beats/min.
• Heart rate is generally refers to the ventricular rate of beating and not the atrial.
Physiological Variations
1. Age: In a newly born infant, the heart rate is about 130 beats/min. it decreases gradually with
age to reach the adult level at 20years, then it tends to remain steady.
2. Sex: heart rate is higher in females. In an adult female, its about 85 beats/min.
3. Time of the day: There is a circadian rhythm (24 hr rhythm) in the heart rate. Its lowest in early
morning (65 beats/min) and highest in the evening (85 beats/min).
4. Rest and sleep: Under basal conditions, with complete physical and mental rest or during deep
quiet sleep, the heart rate slows down to 60 beats/min.
5. Physical training: Athletes have lower heart rate (45-60 beats/min) than non-athletes.
6. Posture: Heart rate increases during standing and returns back to the normal basal value in the
recumbent position.
Note:
• All these physiological variations are caused by variations in the inhibition of vagal tone.
• A lower heart rate is caused by a higher vagal tone and a higher heart rate is caused by a lower
vagal tone to the heart.
How to Count the Heart Rate
1. Counting arterial pulsations:
• There are various sites where arterial pulsations could be felt.
• Radial artery is the commonest used.
• Others sites include: The temporal artery, common carotid artery, subclavian artery,
brachial artery, ulnar artery, iliac artery, femoral artery, popliteal artery, dorsalis
pedis artery
2. Counting the heart sounds using a stethoscope
3. Counting the cycles in the ECG recording
The Control of Heart Rate
• Heart rate is determined by the rate of discharge of impulses from the pace-maker which is
normally the S-A node.
• It is influenced by numerous factors which can be classified as follows:
A. Factors which influence the S-A nodal activity by direct action on the S-A node:
1. Physical factors: A rise in body temperature. The heart rate increases for each 1 oC rise in body
temperature.
2. Mechanical factors: Right atrial distention stretches the S-A nodal cell and increases the heart
rate (Bainbridge effect).
3. Chemical factors: Catecholamines, mild hypoxia and alkalosis have +ve chronotropic effect
→ increase in the heart rate. Cholinergic drugs, severe hypoxia and acidosis have –ve
chronotropic effect → decrease in the heart rate.
B. Factors which influence the S-A nodal activity by influencing the activity of the
medullary cardiovascular centers
• Medullary cardiovascular centers then modify the sympathetic and parasympathetic tone to the
heart to adjust its rate at required level.
• Factors are classified as follows:
1. Higher centers
a) Cerebral cortex: Influences the heart rate through the following
• Condition reflex: Heart rate of a young infant increases when he sees the feeding bottle. The heart
rate of a mother increases when she hears the crying of her baby. The heart rate of a footballer
increases when he sees a football pitch.
b) Hypothalamus and limbic system together with cerebral cortex control the development of
emotions. Fear, anger, elation, sexual excitation etc. all lead to reflex increase in the heart rate and
vasoconstriction which increases the arterial blood pressure. When one remembers or thinks of an
emotional experience the heart rate increases (psychocaridac reflex).
• Voluntarily: Some yogis can increase or decrease their heart rate voluntarily.
C) Inspiratory center:
• During inspiration, the heart rate increases due to irradiation of the inspiratory center activity during
inspiration to the nearby cardiovascular centers to inhibit the cardio-inhibitory center and stimulate
vasoconstrictor center. This leads to an increase in heart rate and vasoconstriction during inspiration.
• Activity of inspiratory center is depressed during expiration. So during expiration the heart rate and
vasomotor tone decreases.
2. Chemical composition of the blood
a) Hypoxia, hypercapnia and acidosis: Hypoxia inhibits the cardio-inhibitory center, thus
helping to increase the heart rate. Hypercapnia and acidosis first stimulate the cardio-
inhibitory center which leads to an initial short period of bradycardia, which is followed
by inhibition of cardio-inhibitory center which leads to an increase in heart rate.
3. Reflexes: Which may be divided into
b) Circulatory reflexes
• Arterial baroreflex: A rise in arterial blood pressure produces reflex decrease in heart rate,
while a fall in arterial blood pressure produces increase in heart rate.
• Atrial stretch reflex (Bainbridge reflex): Increased distention of right atrium or a rise in
the right intra-atrial pressure produces reflex increase in heart rate.
• Ventricular stretch reflex (coronary stretch reflex): Ventricular dilation as towards the
end of diastole stimulates stretch receptors near the coronary blood vessels of the left
ventricular → afferent vagal impulses to the medullary cardiovascular centers → reflex
increase in vagal tone → decrease in heart rate.
• Arterial chemoreflex: Hypoxia, hypercapnia and acidosis stimulate the arterial chemoreceptors
in the aortic body and carotid body, leading to a reflex increase in heart rate and peripheral
vasoconstriction (respiration is stimulated).These receptors are more sensitive to hypoxia than
hypercapnia and acidosis.
• Coronary chemoreflex (Bezold-Jarisch reflex): Are chemoreceptors in the left ventricle around
the coronary blood vessels. Stimulated by certain chemicals as nicotine → reflex bradycardia.
Extra-circulatory reflexes (Reflexes outside the CVS)
• Pulmonary stretch reflex: Inflation of the lung → reflex increase in heart rate. Lung inflation
stimulates the pulmonary stretch receptors in the smooth muscle cells of the small respiratory
airways → afferent vagal signals to the medullary centers → reflex increase in heart rate.
• Pulmonary chemoreflex: substances like serotonin, bradykinin produce reflex slowing of the
heart. These substances stimulate the juxta-capillary receptors in the lungs → afferent vagal
signals to the medullary cardiovascular centers → reflex slowing of the heart.
• Cold reflex: Exposure to cold produces reflex increase in heart rate.
• Pain reflex: Pain sensation usually produces reflex increase in heart rate. However, severe viscera
pain sometimes produces reflex bradycardia.
• Oculo-cardiac reflex: Pressure over closed eyes produces reflex slowing of the heart.
Pressure over the eye stimulates compression receptors in the eye which send signals to the
medullary cardiovascular centers via the oculomotor nerve. Oculo-cardiac reflex may be
used to stimulate the vagal nerve supply to the heart and terminate an attack of paroxysmal
atrial tachycardia.
• Trigger zones reflexes: Are sensitive areas in the body that can initiate reflex severe
bradycardia or even cardiac arrest when stimulated by a strong blow. These zones include
the carotid sinus area, the eye ball, the larynx, the epigastric area and the testes.
• Skeletal muscle reflex: Any voluntary contraction of a muscle produces reflex increase in
the heart rate. The receptors are the kinesthetic receptors in muscles and joints which send
their signals to the medullary cardiovascular centers through sensory nerves.