Hypokinetic pulsations in the mitral area can be caused by
a. the presence of fluid between the left ventricle and the chest wall.
b. decreased subcutaneous tissue in the individual.
c. high-output states such as warm septic shock.
d. left ventricular hypertrophy.
A
Hypokinetic (decreased movement) pulsations in the mitral area can be caused by the presence of fluid between the left ventricle and the chest wall. Two causes of hypokinetic pulsations in the mitral area are pericardial effusion and cardiac tamponade; however, absent pulsations are normal in half of the adult population. In obesity, the excess subcutaneous tissue dampens the apical pulse. Low output states such as shock produce a less palpable apical impulse from the reduced blood volume and decreased myocardial contractility. High-output states such as mitral regurgitation, thyrotoxicosis, severe anemia, and left-to-right heart shunts are potential causes of hyperkinetic pulsations.
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