Apex Beat - Interpretation

Interpretation

• Algorithm for classification of the apex beat characters

Lateral and/or inferior displacement of the apex beat usually indicates enlargement of the heart, called cardiomegaly. The apex beat may also be displaced by other conditions:

• Pleural or pulmonary diseases
• Deformities of the chest wall or the thoracic vertebra

Sometimes, the apex beat may not be palpable, either due to a thick chest wall, or conditions where the stroke volume is reduced; such as during ventricular tachycardia or shock.

The character of the apex beat may provide vital diagnostic clues:

• A forceful impulse indicates pressure overload in the heart (as might occur in hypertension)
• An uncoordinated (dyskinetic) apex beat involving a larger area than normal indicates ventricular dysfunction; such as an aneurysm following myocardial infarction

An algorithm for the classification of some common apex beat characters is shown in the image.