Medically reviewed by Richard N. Fogoros, MD The apical pulse (or precordial impulse) originates from the bottom of the heart and is felt on the outer left chest wall just under the nipple. The apical ...

Frequently, this is at the fifth intercostal space at the midclavicular line. When dilated cardiomyopathy is present, this can be shifted laterally. Also, a hyperdynamic PMI is seen in ...

Tricuspid stenosis is very rare and is discussed further in the valvular heart disease section ... murmur usually heard best at the third intercostal space on the left (Erb's point) at end ...