Table of ContentsView AllTable of ContentsCommon CausesWhen to See a ProviderSymptomsHow to Check Your PulseDiagnosis and TreatmentPreventing Repeat Symptoms
Table of ContentsView All
View All
Table of Contents
Common Causes
When to See a Provider
Symptoms
How to Check Your Pulse
Diagnosis and Treatment
Preventing Repeat Symptoms
A bounding pulse is a strong heartbeat felt over an artery, such as in the neck, wrist, or foot. Possible causes include anxiety, fever, exercise, and an overactive thyroid gland.
Though most causes of a bounding pulse are reversible or treatable and not dangerous, in some cases, it may indicate a heart problem, like severe aortic regurgitation (heart valve disease),
Keep in mind that the term “bounding pulse” is sometimes interchangeable with “heart palpitations” because the two symptoms have some overlapping causes.
That said,heart palpitationsare the general awareness of one’s heart beating. They are often described as a racing, skipping, or fluttering feeling.A bounding pulse refers more specifically to an exaggerated, powerful, or forceful heartbeat.
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Bounding (sometimes called hyperkinetic) pulses are considered normal (although they may require treatment) in the following conditions/ scenarios:
Bounding Pulses in PregnancyBounding pulses in pregnancy may be due to the following:Increased stroke volume, which is a normal response to the hormone-induced widening of the blood vessels throughout the bodyNutritional-related anemia—for example,iron deficiency anemia affects up to 26% of pregnanciesHyperthyroidism—for example,Graves' diseaseis the most common cause, affecting about 0.2% of pregnancies
Bounding Pulses in Pregnancy
Bounding pulses in pregnancy may be due to the following:Increased stroke volume, which is a normal response to the hormone-induced widening of the blood vessels throughout the bodyNutritional-related anemia—for example,iron deficiency anemia affects up to 26% of pregnanciesHyperthyroidism—for example,Graves' diseaseis the most common cause, affecting about 0.2% of pregnancies
Bounding pulses in pregnancy may be due to the following:
More seriously, bounding pulses can signify a heart valve condition calledaortic regurgitation (AR).
The aortic valve is the opening where oxygenated-rich bloodflows from the left ventricle(lower chamber of the heart) into theaorta, the largest blood vessel in the body.
In AR, the aortic valve deteriorates, allowing blood to leak backward from the aorta into the left ventricle. This leakage increases blood volume and pressure in the left ventricle, forcing the heart to work harder to pump blood to the rest of the body.
Though many people with AR have no symptoms for decades, as the condition progresses, the heart muscle thickens and gets bigger to compensate for its increased workload. The increased stroke volume and forceful pumping of the left ventricle can lead to bounding pulses.
Is “Bounding Pulse” the Same as “Collapsing Pulse”?The pulse of severe AR is sometimes described as “collapsing.” This is because the pulse is momentarily forceful (“bounding”) before rapidly disappearing (“collapsing”) as the blood leaks backward through the damaged aortic valve.
Is “Bounding Pulse” the Same as “Collapsing Pulse”?
The pulse of severe AR is sometimes described as “collapsing.” This is because the pulse is momentarily forceful (“bounding”) before rapidly disappearing (“collapsing”) as the blood leaks backward through the damaged aortic valve.
Over time,heart failurecan manifest with severe AR, causing the following symptoms:
Patent ductus arteriosus (PDA)is another potential cause of bounding pulses. It’s a congenital (present at birth) heart defect that is more common in preterm babies.
Other heart-related causes of bounding pulses include:
When to Contact a Healthcare Provider
Undergoing a medical evaluation for bounding pulses is important to ensure that no health condition, such as anemia, thyroid disease, an infection (causing a fever), or a heart problem, is present.
Seek Emergency Medical AttentionSeek medical attention immediately if any of the following symptoms/scenarios accompany your bounding pulses:Lightheadedness or faintingChest painBreathlessnessSevere swelling in your ankles and feetUnusual fatigueHeart rate greater than 120 beats per minute (bpm) or less than 45 bpm while at restHistory of known heart condition, including heart valve disease or arrhythmiaFamily history of recurrent fainting or sudden or unexplained death
Seek Emergency Medical Attention
Seek medical attention immediately if any of the following symptoms/scenarios accompany your bounding pulses:Lightheadedness or faintingChest painBreathlessnessSevere swelling in your ankles and feetUnusual fatigueHeart rate greater than 120 beats per minute (bpm) or less than 45 bpm while at restHistory of known heart condition, including heart valve disease or arrhythmiaFamily history of recurrent fainting or sudden or unexplained death
Seek medical attention immediately if any of the following symptoms/scenarios accompany your bounding pulses:
Possible Symptoms During an Episode
If you are experiencing a bounding pulse, accompanying symptoms depend on the underlying cause.
For example, general symptoms of anemia include:
Likewise,symptoms of excess thyroid hormone in the body(hyperthyroidism) include:
Lastly, if fever is causing bounding pulses, check for signs of infection, such as those of aurinary tract infection,influenza (flu),COVID-19, orviral gastroenteritis(stomach flu), and see a healthcare provider.
Arteriescomprise one part of the circulatory system. They are blood vessels that transport oxygen-rich blood from your heart to your body’s tissues and organs.
Your pulse represents the sudden widening of an artery as blood is abruptly ejected into the aorta and, subsequently, throughout the body.
If you want to check your pulse, do so while lying down in a warm room. Press the tips of your index and middle fingers over one or more of the following arteries:
Grading the Intensity of PulsesIf a provider is performing the pulse exam, the intensity of the pulse can be graded on a scale of 0 to 4+:0means no pulse is felt1 +means a pulse is detectable but faint2 +suggests a slightly more diminished pulse than normal is felt3 +means a normal pulse is felt4 +means abounding pulseis felt
Grading the Intensity of Pulses
If a provider is performing the pulse exam, the intensity of the pulse can be graded on a scale of 0 to 4+:0means no pulse is felt1 +means a pulse is detectable but faint2 +suggests a slightly more diminished pulse than normal is felt3 +means a normal pulse is felt4 +means abounding pulseis felt
If a provider is performing the pulse exam, the intensity of the pulse can be graded on a scale of 0 to 4+:
Dangerous Heart Rate: Understanding Your Levels
Diagnosing and Treating Your Symptoms
Diagnosing the cause of bounding pulses requires the following:
What Is an ECG?AnECG measures the heart’s electrical activity and can help detect abnormal heart rhythms (arrhythmias), which are the most frequent cause of heart palpitations.
What Is an ECG?
AnECG measures the heart’s electrical activity and can help detect abnormal heart rhythms (arrhythmias), which are the most frequent cause of heart palpitations.
Treatment of bounding pulses depends on the underlying cause.
Examples include:
How to Stop Symptoms From Returning
Depending on the cause, there may be no treatment—for example, reassurance if your bounding pulses occur with exercise. In such cases, your bounding pulses should resolve after resting from exercise.
Other treatments may include taking a supplement or medication or seeing a specialist, such as acardiologist(a specialist in heart conditions) orpsychiatrist(a physician specializing in mental health conditions).
Summary
A bounding pulse is a forceful or exaggerated heartbeat felt over an artery in the arms, legs, feet, or neck. Most causes of bounding pulses are normal compensatory responses of the heart. They include fever, anxiety, pregnancy, exercise, anemia, and hyperthyroidism.
Bounding pulses are also classically seen with various heart conditions. A prime example is severe aortic regurgitation, which occurs when the aortic valve doesn’t fully close, causing blood to leak back into the heart. As a result of the increased blood pressure and volume, the heart has to beat more forcefully to eject oxygen-rich blood throughout the body.
Due to similar causes and sensations, “bounding pulse” is sometimes used interchangeably with “heart palpitations.” Technically speaking, heart palpitations are the general awareness of the heart’s activity, and their most common cause is abnormal heart rhythms (arrhythmias).
Diagnosing the origin of bounding pulses involves a medical history, a physical exam (including a heart and pulse exam), various blood tests, and an echocardiogram. Due to the overlap with “heart palpitations,” an ECG is also performed.
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