THE LEFT PARASTERNAL IMPULSE

Abstract

A lift or heave which is palpable at the left sternal edge is an accepted clinical sign of right ventricular hypertrophy. The parasternal impulse has been recorded in normal subjects and in patients with heart disease, and the results are described in this paper. A detailed description of the instrument used to make the recordings has already been published This instrument records absolute displacement of a selected area on the chest wall. By correlating the recordings with clinical examination, chest radiographs, electrocardiograms, and the results of right heart catheterization, we have been able to define, in terms of displacement, the characteristics that distinguish normal from abnormal impulses. We have also attempted to assess the reliability of an abnormal impulse in revealing underlying ventricular and atrial hypertrophy.