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point of maximum impulse (PMI); apical impulse
Normally discrete area of localized contraction at the 5th intercostal space, mid-clavicular line.
Abnormalities:
1) apex displaced, impulse poor & diffuse:
- cardiomyopathy
2) trifid:
- hypertrophic cardiomyopathy
3) tapping quality, localized
- mitral stenosis
4) sustained, but not displaced:
a) aortic stenosis
b) left ventricular hypertrophy
5) hyperdynamic:
- mitral regurgitation
References
- Manual of Medical Therapeutics, 28th ed, Ewald &
McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 128
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed)
Lippincott-Raven, Philadelphia, 1998, pg 38