Posts Tagged ‘MD’

Examinations in  clinical cardiology

It is a brief early systolic outward thrust , followed by late systolic retraction felt by the palpating finger  when  the LV contracts and rotates  ,  the LV apex and the adjacent  interventricular septum hits against the chest wall. It is usually felt at the 5th left intercostal space just inside the mid clavicular line , lasting less than 30% of systole and  occupying less than 3 square cms area.

Source : Horwitz ,signs and symptoms in clinical cardiology .1985. Lippincot 

Should we always be able to palpate an apical impulse ? 

Not really.If apical impulse is not felt in the sitting posture ,  one has to try in the left lateral position .In  thick chest walled persons it may be impossible to feel the apical impulse in any postion. Many times it is so tiny it lies behind a rib and one will not feel it. In  pericardial effusion also apical impulse is absent.

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