Physical examination maneuver

Physical Exam

Right Ventricular Heave

also known as Parasternal heave; left parasternal lift
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Video coming September 2026

How to Perform

With the patient supine or sitting, place the heel of your hand or your fingertips over the lower left sternal border and the subxiphoid area. Feel for a sustained, lifting impulse beneath your hand that is timed with systole, noting its presence, force, and duration.

How to Interpret

Showing all 1 finding

Pulmonary Hypertension

Sustained, lifting left parasternal (right ventricular) heave - a sustained systolic lift felt with the heel of the hand at the lower left sternal border
Rule in
Somewhat helpful
Rule out
—
Evidence:Limited

References

  • Braganza M, Shaw J, Solverson K, Vis D, Janovcik J, Varughese RA, Thakrar MV, Hirani N, Helmersen D, Weatherald J. A Prospective Evaluation of the Diagnostic Accuracy of the Physical Examination for Pulmonary Hypertension. Chest. 2019 May;155(5):982-990. doi:10.1016/j.chest.2019.01.035. PMID 30826305.
  • McGee S. Evidence-Based Physical Diagnosis. 6th 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
Precordial Palpation
Rule in:SHPulmonary Hypertension
Rule out:NHPulmonary 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