{"id":30884,"date":"2020-04-09T08:38:00","date_gmt":"2020-04-09T03:08:00","guid":{"rendered":"https:\/\/johnsonfrancis.org\/professional\/?p=30884"},"modified":"2020-04-09T08:38:00","modified_gmt":"2020-04-09T03:08:00","slug":"palpation-of-diastolic-motion-of-lv","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/palpation-of-diastolic-motion-of-lv\/","title":{"rendered":"Palpation of diastolic motion of LV"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/Skz112veTjw\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">Palpation of diastolic motion of left ventricle (LV)<\/span><\/h2>\n<p>All of us familiar with the systolic motion of the left ventricular apex which is palpated as the apex beat or apical impulse. Two diastolic movements may be palpable:<\/p>\n<ol>\n<li>Diastolic filling of the left ventricle when it is rapid as in mitral regurgitation, dilated left ventricle or ventricle with impaired systolic function. This movement corresponds to and is the mechanical equivalent of third heart sound. This has been described as contributing to the occasional <span style=\"color: #0000ff;\">quadruple apical impulse<\/span> in hypertrophic obstructive cardiomyopathy (HOCM) [1]. It may be noted in this context that <span style=\"color: #ff00ff;\">triple apical impulse<\/span> in HOCM is a combination of two systolic and one diastolic impulse due to atrial contraction. More common is a <span style=\"color: #ff0000;\">double apical impulse<\/span> in HOCM which could be two systolic impulses or one systolic and one presystolic impulse.<\/li>\n<li>A presystolic left&nbsp; ventricular impulse may be felt in conditions with forceful atrial contraction and is the mechanical equivalent of fourth heart sound. This contributes to the triple apical impulse in HOCM as mentioned above. Presystolic impulse is an indicator of left ventricular diastolic dysfunction leading to forceful atrial contraction contributing to ventricular filling.<\/li>\n<\/ol>\n<p>Both these pulsations are best appreciated in left lateral decubitus position with the breath held in expiration.<\/p>\n<p><span style=\"color: #0000ff;\"><strong>Reference<\/strong><\/span><\/p>\n<ol>\n<li>Howard S. Rosman. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK322\/\">Chapter 21 Precordial Impulses<\/a>.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Palpation of diastolic motion of left ventricle (LV) All of us familiar with the systolic motion of the left ventricular apex which is palpated as the apex beat or apical impulse. Two diastolic movements may be palpable: Diastolic filling of the left ventricle when it is rapid as in mitral regurgitation, dilated left ventricle or [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":30887,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[2],"tags":[1195,3192,4039],"class_list":["post-30884","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cardiology","tag-double-apical-impulse","tag-quadruple-apical-impulse","tag-triple-apical-impulse"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Palpation of diastolic motion of LV - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/palpation-of-diastolic-motion-of-lv\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Palpation of diastolic motion of LV - All About Cardiovascular System and Disorders\" \/>\n<meta property=\"og:description\" content=\"Palpation of diastolic motion of left ventricle (LV) All of us familiar with the systolic motion of the left ventricular apex which is palpated as the apex beat or apical impulse. Two diastolic movements may be palpable: Diastolic filling of the left ventricle when it is rapid as in mitral regurgitation, dilated left ventricle or [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/palpation-of-diastolic-motion-of-lv\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2020-04-09T03:08:00+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/palpation-of-diastolic-motion-of-lv\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/palpation-of-diastolic-motion-of-lv\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"Palpation of diastolic motion of LV\",\"datePublished\":\"2020-04-09T03:08:00+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/palpation-of-diastolic-motion-of-lv\\\/\"},\"wordCount\":234,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/palpation-of-diastolic-motion-of-lv\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"keywords\":[\"double apical impulse\",\"quadruple apical impulse\",\"triple apical impulse\"],\"articleSection\":[\"Cardiology\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/palpation-of-diastolic-motion-of-lv\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/palpation-of-diastolic-motion-of-lv\\\/\",\"name\":\"Palpation of diastolic motion of LV - 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