Where is the point of maximal impulse (PMI) typically located?

The point of maximal impulse (PMI) is typically located at the 5th intercostal space at the left mid-clavicular line. This anatomical location corresponds to the position of the left ventricle as it contracts, making this the area where the heartbeat can be palpated most effectively. The PMI is an important finding during a cardiac examination, as it can provide insights into the size and function of the heart.

In a normal, healthy heart, the PMI should be at or near this location, and deviations from this site may indicate underlying conditions such as cardiomegaly or other forms of heart disease. For instance, if the PMI is displaced laterally or downward, it may suggest that the heart is enlarged or that there is an abnormal heart position.

Other locations mentioned, such as the right atrium or the second intercostal space, do not accurately correspond to the PMI. The right atrium is located more toward the right side of the chest and beneath the sternum and is not where the pulsation of the left ventricle can be palpated. The second intercostal space is primarily where the aorta and major blood vessels can be assessed, which is not relevant for determining the PMI. The phrase "