Where is the PMI best palpated?

Where is the PMI best palpated?

• A. 4th/5th Intercostal Space in the Midclavicular Line
• B. 2nd Intercostal Space at the Left Sternal Border
• C. 5th Intercostal Space in the Anterior Axillary Line
• D. 6th Intercostal Space at the Midclavicular Line

Answer: (A)

The PMI, or point of maximal impulse, is the apex beat felt where the left ventricle pushes most strongly against the chest wall. In a healthy adult this is best palpated along the left midclavicular line at about the 5th intercostal space. Some sources describe it as between the 4th and 5th spaces in that line, which accommodates variation in body habitus and technique. That placement matches where the apex impulse is most prominent. Locations at the second intercostal space along the left sternal border correspond to the aortic area, not the apex; a spot along the anterior axillary line at the 5th space is too lateral to capture the apex impulse; and the 6th space is lower than where the apex typically lies.

The PMI, or point of maximal impulse, is the apex beat felt where the left ventricle pushes most strongly against the chest wall. In a healthy adult this is best palpated along the left midclavicular line at about the 5th intercostal space. Some sources describe it as between the 4th and 5th spaces in that line, which accommodates variation in body habitus and technique. That placement matches where the apex impulse is most prominent. Locations at the second intercostal space along the left sternal border correspond to the aortic area, not the apex; a spot along the anterior axillary line at the 5th space is too lateral to capture the apex impulse; and the 6th space is lower than where the apex typically lies.