Displaced point of maximal impulse

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

During a cardiac examination, the normal point of maximal impulse (PMI) should be routinely palpated in the left midclavicular line between the fourth and fifth ribs (normally 2-3 cm in diameter). The normal PMI represents the apical impulse of the left ventricle. A displaced PMI sheds light on abnormalities of the heart, and therefore allows for a correct diagnosis

Differential Diagnosis of a Displaced PMI

In alphabetical order [1]

Chest X Ray

MRI and CT

Echocardiography or Ultrasound

Treatment

Surgery and Device Based Therapy

References

  1. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:46 ISBN 140510368X



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