Having assessed the location and the size of the apical impulse, we now analyze its contour. We feel with light pressure and we can feel the impulse very well. Let’s enhance it, however, by again using a cotton swab to see the type of impulse contour in this patient, and to provide a timing device, let us concurrently put a swab on the carotid impulse, so that we know when systole occurs and can appropriately time and analyze the contour of this apical impulse.