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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.
That means a forceful and hyperdynamic impulse (large amplitude that terminates quickly) can be palpated during physical examination. [1] Hyperdynamic precordium is a physical finding which can be normal or pathological. Some possible etiologies are as followings: [1] Exercise or vigorous activities
Hypertrophic cardiomyopathy (HCM, or HOCM when obstructive) is a condition in which muscle tissues of the heart become thickened without an obvious cause. [8] The parts of the heart most commonly affected are the interventricular septum and the ventricles. [10]
Left ventricular function can be assessed by determining the apical impulse. A normal or hyperdynamic apical impulse suggests good ejection fraction and primary MR. A displaced and sustained apical impulse suggests decreased ejection fraction and chronic and severe MR. This type of murmur is known as the Castex Murmur. Holosystolic (pansystolic)
During development, the majority of the heart muscle is a sponge-like meshwork of interwoven myocardial fibers. As normal development progresses, these trabeculated structures undergo significant compaction that transforms them from spongy to solid. This process is particularly apparent in the ventricles, and particularly so in the left ...
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 ...
The cardiovascular examination is a portion of the physical examination that involves evaluation of the cardiovascular system. The exact contents of the examination will vary depending on the presenting complaint but a complete examination will involve the heart (cardiac examination), lungs (pulmonary examination), belly (abdominal examination) and the blood vessels (peripheral vascular ...
Dyspnea and chest pain commonly occur during daily activities. Syncope may also occur. On physical examination, significant findings include: loud systolic murmur and palpable triple apical impulse due to a palpable presystolic fourth heart sound. Aortic dissection is characterized by severe chest pain that radiates the back.