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Impalpable apex beat

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

If the apex beat is impalpable then the following possibilities should be considered:

  • the patient has an excessively muscular or fat chest wall
  • left pleural effusion, pneumothorax, or emphysema
  • there may be a large pericardial effusion
  • constrictive pericarditis
  • marked mediastinal shift
  • dextrocardia
  • very rarely, massive left ventricular hypertrophy may cause the apex beat to be displaced past the mid-axillary line

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