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

The point of maximal impulse (PMI) is typically located at the midclavicular line in the 5th intercostal space. This location corresponds to the apex of the heart, where the ventricular contraction is most pronounced and is palpable on physical examination. The PMI is an important clinical finding as it can provide information regarding the size and position of the heart, which may be altered in conditions such as heart failure or cardiomegaly.

When assessing the PMI, it is crucial to identify its location accurately. In a normal, healthy adult, the ideal placement allows for standardization in assessments and comparisons across different examinations. Variations from this standard location can indicate pathological conditions that may warrant further investigation.

Other locations mentioned, such as to the left of the sternum or above the xiphoid process, do not accurately represent the typical anatomical positioning of the PMI. The diaphragm is also not the appropriate location for the PMI, as it is located at a lower point in the thoracic cavity, far from where the heart is situated.