You are incorrect - our patient demonstrates a sustained systolic impulse at the lower left sternal edge.
Your choice: Presystolic + sustained systolic
A sustained lower left sternal edge impulse with a presystolic component might be felt in a patient with right ventricular hypertrophy. A presystolic impulse is the palpable equivalent of an audible fourth heart sound. In the video, note the presystolic component occurs just before the carotid impulse and the sustained precordial impulse occurs with the carotid pulse.
