Left ventricular aneurysm physical examination

Left ventricular aneurysm Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]

Overview

The physical examination findings on cardiac examination in patients with LV aneurysm include a diffuse and displaced apical impulse, S3 and/or S4 heart sounds, and murmur of mitral regurgitation.

Physical exam

Appearance of the patient

Patients are usually well-appearing.

Vital signs

High blood pressure with normal pulse pressure may be seen. Tachycardia is another finding.

Cardiovascular

Common findings in patients with LV aneurysm include:

Palpation

• Diffuse, sustained apical systolic thrust and a double impulse.
• Displaced apical impulse to the left of the mid clavicular line.

Auscultation

• Presence of a Third heart sound (S3), and often a fourth sound (S4).
• There may be an apical pansystolic murmur due to the LV wall anatomical distortion, and also from mitral regurgitation, if present.