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The apex beat (lat. ictus cordis), also called the apical impulse, [1] is the pulse felt at the point of maximum impulse (PMI), which is the point on the precordium farthest outwards (laterally) and downwards (inferiorly) from the sternum at which the cardiac impulse can be felt.
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 ...
A forceful apex beat indicates left ventricular pressure overload, while a right ventricular heave suggests right ventricular pressure overload. Other signs provide evidence for specific causes of pressure overload. Hypertension is diagnosed by sphygmomanometry.
Tapping apex beat that is not displaced; Medical signs of atrial fibrillation include: [citation needed] Heart rate is about 100-150/min. Irregularly irregular pulse with a pulse deficit>10. Varying first heart sound intensity. Opening snap is not heard sometimes. Absent a waves in the neck veins. Presystolic accentuation of diastolic murmur ...
Pulmonary valve stenosis is a crescendo-decrescendo systolic murmur. One can hear it best at the left upper sternal border. It has association with a systolic ejection click that increases with inspiration. This finding results from an increased venous return to the right side of the heart. Pulmonary stenosis sometimes radiates to the left ...
This is the ejection stage of the cardiac cycle; it is depicted (see circular diagram) as the ventricular systole–first phase followed by the ventricular systole–second phase. [2] After ventricular pressures fall below their peak(s) and below those in the trunks of the aorta and pulmonary arteries, the aortic and pulmonary valves close ...
Palpitations with chest pain could mean reduced blood flow to the heart. If the person feels lightheaded or faints, arrhythmias should be considered. [1] Positive orthostatic vital signs may indicate dehydration or an electrolyte abnormality. [1] A mid-systolic click and heart murmur may indicate mitral valve prolapse.
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]