parasternal impulse

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A parasternal heave is detected by placing the heel of the hand over the left parasternal region. In the presence of a heave the heel of the hand is lifted off the chest wall with each systole.

A parasternal heave is caused by:

  • right ventricular enlargement, or
  • rarely, severe left atrial enlargement which pushes the right ventricle forwards

Last reviewed 01/2018