You are incorrect - our patient's apical impulse has a presystolic and an early systolic component.
Your choice: Presystolic + sustained systolic
A sustained apical impulse with a presystolic component might be felt in a patient with left ventricular hypertrophy. A presystolic impulse is the palpable equivalent of an audible fourth heart sound. In the video, note the presystolic component occurs just before the carotid pulse and the sustained impulse occurs with the carotid pulse.
