You are incorrect - our patient's lower left sternal edge impulse is sustained throughout systole and there is a presystolic component.
An early systolic and hyperdynamic lower left sternal edge impulse is typically felt when there is an increased right ventricular stroke volume associated with an increased preload and an increased velocity of right ventricular contraction due to reduced afterload. In the video, note the early systolic and hyperdynamic lower left sternal edge impulse occurs with the pulmonary artery impulse.
