Impulse cardiogram in early diagnosis of left ventricular dysfunction in hypertension.

An abnormal apical impulse has long been recog- nized in hypertensive cardiac disease. They showed that with the development of hypertensive cardiac disease, as demonstrated by the electrocardiogram and x-ray, there was an ab- normal prolongation of the apical impulse up to, or beyond, the second heart sound. They also stated that patients with borderline hypertrophy showed inconstant changes in the apical impulse while those without hypertrophy (as shown on the electrocardio- gram and chest x-ray) had an entirely normal impulse.