A weak or absent pulse can signal a medical emergency, such as cardiogenic shock or cardiac arrest. Without prompt medical treatment, both conditions can result in death.
A person may have a weak pulse if their pulse lacks strength or if they have difficulty detecting their pulse when checking for it properly.
The pulse represents how many times per minute the arteries expand and contract in response to the heart pumping blood around the body. A pulse rate is equal to a heartbeat. This means that measuring a person’s pulse measures their heart rate.
This article explains how to identify a weak pulse and lists other symptoms to watch out for. It also outlines potential causes, treatments, and complications. Finally, it describes the outlook for a person with a weak or absent pulse pulse and answers some frequently asked questions.
If a person has a weak pulse, it is important to call 911 immediately. A weak pulse can indicate cardiogenic shock, which is when the heart cannot pump sufficient blood around the body.
An absent pulse can indicate that a person is in cardiac arrest. Cardiac arrest is when a person’s heart stops pumping blood around the body.
How to measure a person’s pulse
The
- the wrists
- the side of the neck
- the inside of the elbow
- the top of the foot
To achieve the most accurate reading, the AHA advises putting a finger over the pulse and counting the number of beats within a 60-second timeframe.
The total number reflects a person’s heart rate in beats per minute (bpm). A typical rate is 60–100 bpm.
A weak or absent pulse may occur due to cardiogenic shock or cardiac arrest.
Causes of cardiogenic shock
A weak pulse may be a symptom of a serious and potentially fatal condition called cardiogenic shock.
Most of the time, cardiogenic shock occurs due to a severe heart attack. Other causes include:
- viral infections
- an atypical heart rhythm, called an arrhythmia
- a blood clot in the lungs
- progression of preexisting congestive heart failure
- valvular heart disease, such as native valve disease
- endocarditis
- aortic dissection
Other symptoms of cardiogenic shock
Besides a weak pulse, other possible symptoms of cardiogenic shock include:
- a sudden, rapid heartbeat
- low blood pressure
- rapid breathing
- extreme shortness of breath
- sweating
- pale skin
- cold hands or feet
- absent or infrequent urination
- loss of consciousness
- heart attack symptoms, if a heart attack is the cause
- an altered mental status or confusion
- swelling
Causes of cardiac arrest
A weak or absent pulse
Cardiac arrest occurs when the heart’s electrical system malfunctions and the heart stops beating properly. This electrical issue causes the heart’s pumping function to stop.
This can happen as a result of heart arrhythmias, such as:
- ventricular fibrillation
- ventricular tachycardia
- asystole
- pulseless electrical arrhythmia
Some causes of heart arrhythmias that may lead to cardiac arrest include:
- low oxygen levels
- hypothermia
- a pulmonary embolism, which is a blockage in the pulmonary artery
- a heart attack
- toxins
Other symptoms of cardiac arrest
Some other possible symptoms of cardiac arrest include:
- absent breathing or breathing difficulties
- sudden collapse and loss of consciousness
- unresponsiveness to shouting or shaking
The treatment for a weak or absent pulse depends on the cause.
If a person is showing additional symptoms indicative of a cardiogenic shock, a heart attack, or cardiac arrest, it is important to phone the emergency services immediately.
Emergency care
In the case of cardiac arrest, a person may require CPR.
In a situation where performing CPR on an adult may be necessary, the Red Cross recommends doing the following:
Phase one: Assessment
First, a person will need to assess the person and the scene using the following steps:
- Check the person’s responsiveness: This involves tapping them and loudly asking if they are OK. If they appear unresponsive, check the following:
- their breathing
- whether they appear to be experiencing life threatening bleeding
- if there are signs of any other life threatening conditions
- Call 911: If the person is unresponsive, gasping for air, or not breathing, call 911.
- Check the scene and prepare: This involves ensuring it is safe to perform CPR. It is best to use personal protective equipment where available.
Phase two: Performing CPR
To perform CPR on an adult, a person will need to kneel beside the individual and place them on their back on a firm, flat surface.
Compressions
They can then perform 30 chest compressions using the following steps:
- Place both hands on the center of the person’s chest.
- Position your shoulders directly over your hands, and lock both your elbows.
- Press downward to a depth of at least 2 inches.
- Repeat compressions 100–120 times per minute, allowing the chest to return to its normal position after each compression.
Breaths
A person can then give the individual two breaths using the following steps:
- Tilt the person’s head back and lift their chin to open their airway.
- Pinch the person’s nose shut. Take a breath and, using your mouth, create a complete seal over the other person’s mouth.
- Ensure each breath lasts around 1 second and causes the person’s chest to rise. Allow the air to exit before administering the next breath.
- If the person’s chest does not rise, their airway may be blocked. Try tilting their head again or checking their airway for an obstruction.
Next steps
The person can continue performing sets of 30 chest compressions followed by 2 breaths. They should use an automated external defibrillator as soon as one becomes available.
Follow up care
The follow-up treatment for a weak or absent pulse depends on the underlying cause. However, these signs typically indicate a serious underlying condition that requires a period of treatment and close monitoring in a hospital setting.
People who experience a weak or absent pulse may develop different complications depending on the underlying cause. Both cardiogenic shock and cardiac arrest can be fatal without immediate treatment.
Cardiogenic shock complications
According to a
- kidney failure
- heart arrhythmias
- cardiac arrest
- a ventricular aneurysm, which is a weak spot in the wall of one of the heart’s ventricles
- strokes
- blood clots
The condition can be fatal.
Cardiac arrest complications
According to the
- neurological injury due to inadequate blood flow to the brain
- heart failure
- muscle weakness
- kidney injury or failure
- blood clots
- infection
- strokes
- gastrointestinal bleeding
The outlook for individuals experiencing a weak pulse depends on the underlying cause.
Outlook for those with cardiogenic shock
According to a 2023 review, cardiogenic shock is fatal in
However, a person can survive with prompt and appropriate medical treatment.
Outlook for those experiencing cardiac arrest
According to the Centers for Disease Control and Prevention (CDC),
The
- the amount of time that passes between the person collapsing and the start of CPR or defibrillation
- the quality of CPR or defibrillation
- whether the survivor had neurological function during or immediately following CPR
The AHA adds that cardiac arrest can result in brain injury and that this is typically associated with a worse outlook.
Below are some answers to common questions about a weak or absent pulse.
Can anxiety cause a weak pulse?
It is not clear whether anxiety can directly cause a weak pulse.
However, the
Is a person’s pulse weak during a heart attack?
A person’s pulse rate represents their heart rate.
The
A person may have a weak pulse during a heart attack if the lack of blood flow to the heart causes cardiac arrest.
Learn more about a person’s heart rate during a heart attack.
Can a pulse be fast but weak?
Tachycardia is the medical term for a rapid heart rate measuring more than
Supraventricular tachycardia (SVT) is a type of tachycardia that occurs due to an electrical abnormality in the upper chambers of the heart.
According to the
This could result in a fast but weak pulse. Alternatively, a person with SVT may present with a strong, throbbing pulse over one of their arteries.
A weak or absent pulse can signal a medical emergency, such as cardiogenic shock or cardiac arrest. Without urgent treatment, both conditions can result in serious health complications. They can also be fatal.
It is important to take the pulse correctly to establish whether an individual has a weak or absent pulse. The best areas to check are the wrists, the sides of the neck, the inside of the elbow, and the top of the foot.
People who have a weak or absent pulse may show other signs of a medical emergency, such as absent or labored breathing, loss of consciousness, and sudden collapse. If a person has an absent pulse, someone around them should begin CPR immediately and call for medical assistance.