What Is the Difference Between Apical and Radial Pulse?

what is the difference between apical and radial pulse
Apical pulse is felt over the left side of your chest over your heart, whereas radial pulse is felt at your wrist

The main difference between apical and radial pulse is that apical pulse is felt over the left side of your chest over your heart, whereas radial pulse is felt at your wrist.

The table below outlines the differences between apial and radial pulse.

Table: Apical vs. radial pulse
Apical pulse Radial pulse
Pulse felt over the left side of your chest over the apex of your heart Pulse felt at your wrist
May sometimes be heard with heart murmurs or other sounds Only the presence or absence of pulse and its speed and character can be heard
Gives you the best idea of heart contractions Can be lost if the heart pumps blood very weakly
Cannot help measure blood pressure Can help measure blood pressure

Abnormal apical pulse rate may indicate:

  • Heart disease
  • Heart failure
  • Overactive thyroid gland

Medications that can affect apical pulse rate include:

  • Beta-blockers
  • Antidysrhythmic medications
Abnormal radial pulse may indicate a blockage in the artery, as well as the conditions described in apical pulse

How are apical pulse and radial pulse measured?

Apical pulse

  • You will be asked to sit or lie down.
  • Your physician will physically locate the apical pulse over the left center of your chest.
  • Using a stethoscope, your physician will listen to the pulse for a full minute.
  • Each pulsation is counted as one beat.

Radial pulse

  • While keeping your palm facing upward, look at the area between the wrist bone and tendon at the side of your thumb on either wrist.
  • After locating the radial artery, use the tip of the index and third finger of your other hand to feel the pulse in your radial artery.
  • Apply sufficient pressure to feel each beat. Avoid pushing too hard because it may obstruct blood flow.
  • Count the pulse while looking at a watch for one minute.
  • Record your pulse rate for 60 seconds. If you measure for 30 seconds, multiply the counted pulse by two.

What is a pulse deficit?

The difference between apical and radial pulse is called pulse deficit. If your physician finds any irregularity in apical pulse, they will check for pulse deficit, which requires both apical and radial pulse measurements taken simultaneously. They should be measured for one full minute, with one person signaling the other to start counting.

The formula for pulse deficit is as follows:

Apical pulse rate - radial pulse rate = pulse deficit

A pulse deficit of zero does not indicate any underlying medical conditions. However, a difference may signal a problem with cardiac function or efficiency or coarctation of the aorta (narrowing of the aorta after it emerges from the heart).

If a pulse deficit is detected, it may indicate that the heart does not pump sufficient blood to meet the needs of the body’s tissues. More tests, such as a Doppler ultrasound or echocardiogram, may be needed.


Heart Disease: Causes of a Heart Attack See Slideshow

Health Solutions From Our Sponsors

Image Source: Layla Bird / Getty Images

Mayo Clinic. How to take your pulse. https://www.mayoclinic.org/how-to-take-pulse/art-20482581

Johns Hopkins. Radial Pulse. https://ictr.johnshopkins.edu/wp-content/uploads/2015/01/Skills_-Radial-Pulse.pdf

Elkin MK, Perry AG, Potter PA. Nursing interventions & clinical skills, 5th ed. St. Louis, Mo: Mosby. 2007.