Question

Which abnormal conditions may affect the location of the apical impulse?

Answer 1

Answer;

Cardiac enlargement:

- Left ventricular dilation (volume overload) displaces impulse down and to the left ans increases size more that one space.

-A sustained impulse with increased force and duration but no change in location occurs with left ventricular Hypertrophy and no dilation (pressure overload)

- Pulmonary emphysema which makes it non-palpable from the lung sound overriding heart sound.

Explanation;

• Apical impulse is a point of maximal impulse; pulsation created as the left ventricle rotates against the chest wall during systole.
• When visible, it occupies the fourth or fifth intercostal space, at or inside the midclavicular line. It occurs during systole (short, normally first 1/2 of systole).
• It is normally 1 ×2 cm in size.