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The apex cardiac beat: not a reliable clinical sign in elderly patients
E Mulkerrin1, R Saran, R Dewar
1Department of Geriatric Medicine, St Woolos' Hospital, Newport, Gwent.
Age and Ageing
|July 1, 1991
Abstract:
To assess its reliability as a marker of cardiomegaly in elderly patients, we compared a clinical assessment of heart size with that calculated from chest radiography. In 100 hospitalized subjects of median age 78 years, the apex beat was palpable in only 35% and its palpability declined with increasing age. Even when palpable, the apex beat had low specificity (74%) and sensitivity (69%) as a marker of cardiomegaly and its positive predictive value (69%) and negative predictive value (74%) were poor. The clinical assessment of heart size in elderly hospitalized patients should be interpreted with caution.