Where is the point of maximal impulse located?

• A. Right lower sternal border
• B. Right upper chest
• C. Left upper chest
• D. Left midclavicular line at the 5th intercostal space

Answer: (D)

The point of maximal impulse is the apex of the heart, where the left ventricle’ s contraction pushes most strongly against the chest wall. In a typical adult, you can feel this impulse best at the left midclavicular line around the fifth intercostal space, where a brief tapping sensation is felt during systole. This location corresponds to the heart’s apex, not the other areas described. The right lower sternal border sits along the tricuspid area, the left upper chest is toward the base of the heart, and the right upper chest isn’t where the strongest impulse is felt. So the correct spot is the left midclavicular line at the fifth intercostal space.