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August 14, 1967

The Apex Cardiogram

Author Affiliations

From the Institute for Cardiovascular Diseases, Good Samaritan Hospital, Phoenix, Ariz. Dr. Tippit is a fellow in cardiovascular disease at the Good Samaritan Hospital.

JAMA. 1967;201(7):549. doi:10.1001/jama.1967.03130070069023

Apex cardiography is the recording of movements of the chest wall over the apex of the heart. The subject is placed in a semilateral decubitus, and the left arm is raised. The point of strongest impulse in expiratory apnea is located by the examiner, and a bell or funnel with a diameter of 2.5 to 3.5 cm is held there firmly. If a phonocardiogram is obtained simultaneously, a single cup is used with a small side-extension for attachment of the rubber tubing for the apex cardiogram. Displacements of the chest wall within the area of the rim cause pressure changes in the air in the pickup and tubing; the latter connects to a piezoelectrical crystal, whence voltage changes are amplified and conducted to an oscilloscope and photographic recorder or to a direct-writing instrument. The record shows upward and downward movements corresponding to the impulses at the apex. Vibrations within the