(This is a Written Question Of Final Professional MBBS ( Medicine) Examination of Bangladesh)
Shifted Downwords Laterally –
Left Ventricular Hypertrophy Due To .
• Systemic Hypertension.
• Vulvular Heart Disease - Aortic Stenosis, Aortic Regurgitation, Mitral Regurgation.
• Dilalted Cardiomyopathy.
• Ischemic Heart Disease.
• Hyperdyanamic Circulation ( Anemia, Thyrotoxicosis, Beriberi)
Sifted Only Laterally –
Right Ventricular Hypertrophy Due To.
• Cor Pulmonale.
• COPD.
• Pulmonary HTN.
Other Things you Need to Know.
Precardium: Palpation
* 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.
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