Pulse and heart rate are closely related but not technically the same thing. Most of the time they produce the same number, which is why people use the terms interchangeably. But they measure two different events in your body, and in certain medical conditions, the two numbers can actually diverge.
What Each Term Actually Means
Your heart rate is the number of times your heart squeezes per minute. Each squeeze pushes blood out into your arteries. Your pulse, on the other hand, is the number of times your arteries expand and contract per minute in response to that blood flow. When you press your fingers to your wrist, you’re not feeling your heart directly. You’re feeling a pressure wave traveling through your arteries as they stretch slightly with each surge of blood.
That pressure wave starts when the heart ejects blood into the aorta, distending the arterial wall and generating a compression wave that travels outward through the body’s network of arteries. By the time it reaches your wrist, roughly a meter from your heart, it’s still strong enough to feel under your fingertips. So the pulse is essentially the downstream echo of a heartbeat, not the heartbeat itself.
When the Two Numbers Don’t Match
In a healthy heart with a regular rhythm, every squeeze produces a pulse beat at the wrist. Heart rate and pulse rate are identical, and there’s no practical reason to distinguish them. The situation changes with certain heart rhythm problems, most notably atrial fibrillation (AFib), the most common cardiac arrhythmia.
During AFib, the heart’s electrical signals become chaotic. Some of those signals trigger a contraction that’s too weak to push enough blood into the arteries for you to feel at the wrist. The heart still squeezed, so it counts toward heart rate, but no corresponding pulse arrives at your fingertips. The gap between the two numbers is called a pulse deficit. If a stethoscope on the chest counts 110 beats per minute but the wrist pulse reads only 90, the pulse deficit is 20. A larger deficit generally signals poorer blood flow to the body’s periphery.
To measure a pulse deficit precisely, two nurses often work together: one listens to the heartbeat through a stethoscope placed on the chest (the apical pulse) while the other counts the pulse at the wrist, both timing their counts to the same 60-second window. A single clinician can also do it by measuring each site separately within a few minutes of each other.
Normal Resting Ranges
For most adults, a normal resting heart rate falls between 60 and 100 beats per minute. Athletes and very active people can sit comfortably at 40 to 60 bpm because their hearts pump more blood per beat. A resting rate consistently above 100 is called tachycardia; below 60 is bradycardia, though in fit individuals a low rate is usually harmless.
Your pulse should fall in the same range. If you count your pulse and consistently get a number noticeably lower than what a chest monitor or ECG reads, that discrepancy is worth mentioning to a doctor, because it could point to an irregular rhythm you haven’t noticed.
How to Check Your Pulse Accurately
The two most common spots are the radial artery at the wrist and the carotid artery in the neck.
For a wrist reading, turn your palm face up. Place the tips of your index and middle fingers in the groove between the wrist bone and the tendon on the thumb side. Press gently until you feel a rhythmic beat. Too much pressure will block blood flow and make the pulse disappear. Count the beats for a full 60 seconds while watching a clock. Sit and rest for several minutes beforehand so you’re measuring a true resting rate.
For a neck reading, place two fingertips in the groove beside your windpipe on one side. Never press both sides of the neck at the same time, as this can make you lightheaded or even faint. The carotid pulse is stronger and easier to find, which makes it useful during exercise when blood may have shifted away from your extremities. If you’ve ever been told you have plaque buildup in your neck arteries, skip this site entirely.
How Accurate Are Smartwatches?
Most wrist-worn devices estimate heart rate using light sensors that detect changes in blood volume under the skin, essentially reading your pulse optically rather than through touch. At rest or during steady, moderate exercise like cycling, these devices are reasonably accurate. A study comparing four popular wearables against a continuous ECG (the gold standard) found that the Apple Watch and TomTom Runner deviated from the ECG by less than 1 to 2 beats per minute on average across all activity levels.
Accuracy drops during high-intensity or erratic movements. At heart rates above 150 bpm, some devices underestimated heart rate significantly. The Fitbit Charge underread by about 12 bpm on average, and the Samsung Gear 2 was so far off at high intensities that its readings were essentially unusable. If you rely on your watch during intense interval training, CrossFit, or heavy lifting, a chest strap monitor will give you a more reliable number. For everyday resting checks and moderate cardio, most current-generation smartwatches do a solid job.
Pulse Tells You More Than Just a Number
Beyond counting beats, a pulse has qualities that carry useful information. A normal pulse feels steady and moderately strong. A “thready” pulse, one that’s weak and hard to detect, can signal low blood pressure, dehydration, or poor circulation. A “bounding” pulse, where each beat feels exaggerated and forceful, can show up with fever, anxiety, or certain heart valve problems. Clinicians grade pulse strength on a 0 to 3 scale: 0 means no pulse is detectable, 1 is weak, 2 is normal, and 3 is bounding.
You can notice some of these qualities yourself. If your pulse at the wrist ever feels irregular, skipping beats or coming in unpredictable clusters, that pattern is more diagnostically meaningful than the rate alone. Occasional skipped beats are common and usually benign, but a persistently irregular rhythm is one of the hallmark signs of AFib and worth getting checked with an ECG.