<unk>  occurs during right ventricular hypertrophy (i.e. enlargement) or very rarely severe left atrial enlargement. This is due to the position of the heart within the chest: the right ventricle is most anterior (closest to the chest wall). Hypertrophy of the right side of the heart will occur when the right side of the heart chronically contracts against higher pressure. This occurs in the setting of valvular disease i.e. pulmonary valve, and in the setting of respiratory disease whereby the pressure in the pulmonary artery becomes elevated (e.g., chronic obstructive pulmonary disease). An example of a condition where<unk>  can be felt is cor pulmonale. This impulse may also be felt in dilated right ventricular myopathy. The palpation of dilated myopathy differs in that the impulse tends to be vigorous and brief. This is in contrast with the sustained impulse of the hypertrophied right ventricle. A<unk>  may also be felt in mitral stenosis. A left ventricular<unk>  (or lift) suggests the possibility of aortic stenosis.
Parasternal heave
Apex beat
Broadbent inverted sign
Stenvers projection
Ridged band
Stereoblindness
Loop mark
Overriding aorta