Physical examination maneuver

Physical Exam

Precordial Palpation

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Video coming September 2026

How to Perform

With the patient supine, and in the left lateral decubitus position as needed, use the fingerpads and palm to palpate the precordium at the apex and along the left sternal border and base. Locate and characterize the apical impulse, and feel for abnormal movements such as a sustained heave or lift, a palpable thrill overlying a loud murmur, or palpable heart sounds.

How to Interpret

Showing all 2 findings

Pulmonary Hypertension

Left parasternal heave (sustained right ventricular lift) on precordial palpation
Rule in
Somewhat helpful
Rule out
—
Evidence:Limited
Palpable P2 (palpable pulmonary-valve closure) on precordial palpation
Rule in
Not helpful
Rule out
Not helpful
Evidence:Limited

References

  • Shellenberger RA, Imtiaz K, Chellappa N, Gundapanneni L, Scheidel C, Handa R, Bhat A. Physical Examination for the Detection of Pulmonary Hypertension: A Systematic Review. Cureus. 2021 Sep 16;13(9):e18020. doi:10.7759/cureus.18020. PMID: 34692270.
  • Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
  • Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Related Diagnoses

Pulmonary Hypertension

Related Systems / Regions

CardiovascularThorax

Related Bedside Tests

🔒Sign in
Cardiac Auscultation
Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more
Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more
🎬Video coming Sept 2026
Right Ventricular Heave
aka Parasternal heave; left parasternal lift
Rule in:SHPulmonary Hypertension
🎬Video coming Sept 2026
Jugular Venous Pressure
Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more
Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more
🎬Video coming Sept 2026
Lung Auscultation
Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more
Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more
🎬Video coming Sept 2026
Oxygen Saturation
aka Pulse oximetry
Rule in:SHPneumonia, IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure +5 more
Rule out:IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure, IEPeripheral Artery Disease +4 more
🎬Video coming Sept 2026
Respiratory Rate
Rule in:SHPneumonia, IEHeart Failure, IEIncreased Intracranial Pressure +3 more
Rule out:MHPulmonary Embolism, IEHeart Failure, IEIncreased Intracranial Pressure +3 more