Sustained PMI correlates to what?

• A. Chronic Pressure Overload With an Increased After-Load
• B. Acute Volume Overload
• C. Reduced Cardiac Output
• D. Myocardial Infarction

Answer: (A)

A sustained PMI signals left ventricular hypertrophy from long-standing pressure overload. When afterload is chronically high—such as in systemic hypertension or aortic stenosis—the heart compensates by developing concentric hypertrophy, thickening the ventricular wall. This structural change makes the apex impulse stronger and last longer during systole, producing a sustained thrust that can be felt at the point of maximal impulse.

In contrast, acute volume overload tends to produce a brisk, hyperdynamic impulse that is more brief or diffuse rather than sustained; reduced cardiac output often weakens the impulse; and myocardial infarction can disrupt wall motion and typically doesn’t create the characteristic sustained, hyperactive impulse of hypertrophy.