Also, left ventricular failure leads to pulmonary edema which increases and may impede breathing if the patient is laid flat.
Lighting should be adjusted so that it is not obscured by the examiner who will approach from the right hand side of the patient as is medical custom.
The pulses may be: The valve areas are palpated for abnormal pulsations (palpable heart murmurs known as thrills) and precordial movements (known as heaves).
It can be impalpable for a variety of reasons including obesity, emphysema, effusion and rarely dextrocardia.
One should comment on To complete the exam blood pressure should be checked, an ECG recorded, funduscopy performed to assess for Roth spots or papilledema.