Program Progress:
You are incorrect - our patient's apical impulse contour is sustained throughout systole and there is a presystolic component.
Your choice: Sustained systolic + early diastolic
A sustained apical impulse with an early diastolic component might be felt in a patient with a dilated left ventricle associated with volume overload and/or left ventricular failure. The diastolic component is the palpable equivalent of an audible third heart sound. In the video below, note the sustained apical impulse occurs with the carotid pulse and the early diastolic component occurs just after the carotid pulse.
