Program Progress:
You are incorrect - our patient's apical impulse contour is sustained throughout systole and there is both a presystolic and an early diastolic component.
Your choice: Double systolic + presystolic
A double systolic impulse suggests the development of mid systolic obstruction to left ventricular outflow. A presystolic impulse is the palpable equivalent of an audible fourth heart sound. In the video, note that the presystolic component occurs just before the carotid pulse and the double systolic impulse occurs with the carotid pulse.
