Cardiac impulse in hypertrophic obstructive cardiomyopathy.

A double apical impulse has been described as a physical sign in hypertrophic obstructive cardiomyopathy (Mounsey, 1959; Braunwald et al., 1960; Boiteau and Allenstein, 1961; Pare et al., 1961; Benchimol, Legler, and Dimond, 1963; Cohen et al., 1964; Gillam, Deliyannis, and Mounsey, 1964; Tafur, Cohen, and Levine, 1964). In this study we have used the impulse cardiogram, which is an optical record of what the hand feels, to determine more exactly the nature of these abnormalities of the cardiac impulse. Our object has been to assess the clinical significance of the different forms of cardiac impulse in this disease, relating them to the underlying heemodynamic disturbances.