Left ventricular aneurysm physical examination

Left ventricular aneurysm Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]

Overview

Physical findings on cardiac examination in patients with LV aneurysms include diffuse displaced apical impulse, S3 and/or S4 heart sounds and mitral regurgitation murmur.

Physical exam

Appearance of the patient

Patients are usually well-appearing.

Vital signs

High blood pressure with normal pulse pressure may be seen. Tachycardia is another finding.

Cardiovascular

Common physical findings of LV aneurysm include:

Palpation

• Diffuse, sustained apical systolic thrust and a double impulse.
• Displaced apical impulse to the left of the mid clavicular line.

Auscultation

• Third heart sound (S3) and often a fourth sound (S4) are present.
• There may be an apical pansystolic murmur due to LV wall anatomical distortion an if mitral regurgitation is present.