The point of maximal impulse (PMI) is best palpated at which location in a healthy adult?

The point of maximal impulse (PMI) is best palpated at which location in a healthy adult?

• A. Left fifth intercostal space at the midclavicular line
• B. Right fifth intercostal space at the sternal border
• C. Left second intercostal space at the sternal border
• D. Left seventh intercostal space at the midaxillary line

Answer: (A)

The main idea here is the apical impulse, or PMI, which is the impulse of the left ventricle as it moves toward the chest wall during systole. In a healthy adult, the apex of the heart sits over the left chest wall around the fifth intercostal space along the midclavicular line. Palpating in this location captures the most prominent, brief impulse when the ventricle contracts, making it the best spot to feel the PMI. The other locations either correspond to different cardiac areas (like the base near the second intercostal space) or are too low or too far lateral to represent the apex.

The main idea here is the apical impulse, or PMI, which is the impulse of the left ventricle as it moves toward the chest wall during systole. In a healthy adult, the apex of the heart sits over the left chest wall around the fifth intercostal space along the midclavicular line. Palpating in this location captures the most prominent, brief impulse when the ventricle contracts, making it the best spot to feel the PMI. The other locations either correspond to different cardiac areas (like the base near the second intercostal space) or are too low or too far lateral to represent the apex.