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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 ...
Pulse deficit is a condition in which a person has a difference between their pulse rate and heart rate. It can be observed by simultaneous palpation at the radial artery and auscultation using a stethoscope at the PMI, near the heart apex , for example.
Other possible exam findings are bounding carotid and peripheral pulses. These are also known as Corrigan's pulse or Watson's water hammer pulse. Another possible finding is a widened pulse pressure. Mitral stenosis presents as a diastolic low-pitched decrescendo murmur. It is best heard at the cardiac apex in the left lateral decubitus position.
An S3 heart sound is best heard with the bell-side of the stethoscope (used for lower frequency sounds). A left-sided S3 is best heard in the left lateral decubitus position and at the apex of the heart, which is normally located in the 5th left intercostal space at the midclavicular line.
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