Describe Pulsation in cardian examination?
1) Apex impulse; lowest and outermost point of definite cardiac pulsation.
2) Prominent pulsations in left parasternal region suggest RV enlargement, in 3rd left ICS suggest pulmonary artery enlargement and in 2nd right ICS suggest, aortic enlargement.
3) Other pulsations:
1. Suprasternal notch suggests aneurysm of arch of aorta.
2. Cardotid pulsations in neck in patients with hyperdynamic circulation, e.g., thyrotoxicosis AR.
3. Over the scapulae as in coarctation of aorta.
4. In epigastriunl where it could be normal aortic pulsations as in thin persons or due to aortic aneurysm or it could be hepatic pulsation from TR.