How should you palpate the point of maximal impulse (PMI)?

The point of maximal impulse (PMI) is an important landmark in assessing cardiac function and can provide valuable information about the heart's condition. Palpation of the PMI is performed by placing a hand over the precordial area, typically at the left fifth intercostal space at the midclavicular line.

In some patients, particularly those with normal heart size and function, the PMI may be easily palpated. Conditions such as heart disease, left ventricular hypertrophy, or an enlarged heart can cause the PMI to be displaced or rendered more palpable. It’s crucial to recognize that the ability to palpate the PMI can vary significantly from one patient to another due to individual anatomical and physiological differences.

In healthy individuals, the PMI may not always be noticeable, while in patients with heart conditions, it might be more prominent. Therefore, a nuanced approach that encompasses a diverse range of clinical presentations is essential for effective assessment.