We also felt movement at the mid-to-lower left sternal edge. Now, that’s the more usual area when you have parasternal movement, to feel impulses. Let’s time that lower and mid left sternal edge movement and, in this case, we can readily do it against the pulmonary artery, because we already know that that upper left sternal edge pulmonary artery impulse moves during systole. Let’s observe the tip of the cotton swab at the lower left sternal edge and compare it to that at the upper left sternal edge. [Cut-away]
Choose the best description of the lower left sternal edge impulse in our patient: