Where is the apical impulse located? a. in the fifth intercostal space at the midclavicular line b. in the third intercostal space at the left sternal border c. in the second intercostal space at the left sternal border d. in the second intercostal space at the right sternal border?

The apical impulse, also known as the apex beat, is the pulse sensed at the fifth intercostal space at the midclavicular line. It is the same pulse assessed when looking for the point of maximum impulse or PMI. An alteration of the apical impulse may indicate cardiomegaly or heart enlargement. It may also imply other conditions such as chest wall deformity or a pulmonary disease.