Palpation of precordium and adjacent areas

Palpation of precordium and adjacent areas
Palpation initially confirms the findings of inspection and further looks for new findings.

Apex beat: Apex beat is defined as the lowest and outer most point of definite cardiac impulse. If apex beat is not felt on left side, immediately check on right side or else we might miss a dextrocardia. There some who even palpate both sides simultaneously for this reason. Apex beat is initially felt with the palm of the hand and then localized with the index finger. Sometimes it may be difficult to palpate in obese individuals and in those with emphysema. Palpation in held expiration and in the left lateral position may help in localization. Normal apex beat is felt in the 5th left intercostal space, typically about 1 cm medial to the mid clavicular line. Tapping apex beat is the palpable counterpart of a loud first heart sound in mitral stenosis. A forceful apex beat is seen in regurgitant lesions like aortic and mitral regurgitation. It is also called a hyperdynamic apex. Sustained apex beat is both forceful and sustained, and is characteristic of left ventricular hypertrophy of severe aortic stenosis. Dyskinetic apex in left ventricular aneurysm is a see-saw pulsation with an additional out of phase bulge above the lowest impulse. Point of maximum impulse is sometimes checked when the apical impulse is diffuse and difficult to localize. Pulse – apex deficit is a term used in atrial fibrillation to note the difference between the pulse...

Source: Cardiophile MD - September 23, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: HBC Source Type: blogs