Palpate the precordium with the palmar surface of your hand over the aortic, pulmonary, parasternal and apical areas of the heart.
Determine the lower and outermost precardiac impulse, the apical impulse.
Press your finger over the apical impulse identify its location, amplitude, duration and assess the rapidity of the upstroke and downstroke.
Normal:
In thin individuals, the apical impulse is recognizable. Apical impulse is normally in 5th interspace just medial to midclavicular line and is about 1-2 cm in diameter. The apical impulse feels like a gentle tap and is small in amplitude and corresponds to first two thirds of systole.
