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The apex beat is assessed for size, amplitude, location, impulse and duration. There are specific terms to describe the sensation such as tapping, heaving and thrusting. Often the apex beat is felt diffusely over a large area, in this case the most inferior and lateral position it can be felt in should be described as well as the location of ...
Sometimes, the apex beat may not be palpable, either due to a thick chest wall, or conditions where the stroke volume is reduced; such as during ventricular tachycardia or shock. The character of the apex beat may provide vital diagnostic clues: A forceful impulse indicates volume overload in the heart (as might occur in aortic regurgitation)
Findings on clinical examination depend on the severity and duration of MR. The mitral component of the first heart sound is usually soft and with a laterally displaced apex beat, [6] often with heave. [7] The first heart sound is followed by a high-pitched holosystolic murmur at the apex, radiating to the back or clavicular area. [6]
The presence of a murmur at the apex can be misinterpreted as mitral regurgitation. However, the apical murmur of the Gallavardin phenomenon does not radiate to the left axilla and is accentuated by a slowing of the heart rate (such as a compensatory pause after a premature beat) whereas the mitral regurgitation murmur does not change. [2]
Pressure overload may affect any of the four chambers of the heart, though the term is most commonly applied to one of the two ventricles. Chronic pressure overload leads to concentric hypertrophy of the cardiac muscle, which can in turn lead to heart failure , myocardial ischaemia or, in extreme cases, outflow obstruction.
While both ventilation and perfusion increase going from the apex to the base, perfusion increases to a greater degree than ventilation, lowering the V/Q ratio at the base of the lungs. The principal factor involved in the creation of this V/Q gradient between the apex and the base of the lung is gravity (this is why V/Q ratios change in ...
It is recorded as arterial beats per minute or BPM. Although the pulse and heart beat are related, they are not the same. For example, there is a delay between the onset of the heart beat and the onset of the pulse, known as the pulse transit time, which varies by site. Similarly measurements of heart rate variability and pulse rate variability ...
A slow heart rate of 60 or less beats per minute is defined as bradycardia. A fast heart rate of more than 100 beats per minute is defined as tachycardia. An arrhythmia is defined as one that is not physiological such as the lowered heart rate that a trained athlete may naturally have developed; the resting heart rates may be less than 60 bpm.