You are incorrect - our patient demonstrates a sustained systolic impulse at the lower left sternal edge.


Your choice: Sustained systolic + early diastolic

A sustained lower left sternal edge impulse with an early diastolic component might be felt in a patient with a dilated, failing right ventricle. The diastolic component is the palpable equivalent of an audible third heart sound. In the video, note the sustained precordial impulse occurs with the pulmonary artery impulse and the early diastolic component occurs just after.

Hyperkinetic