title: The apex cardiac beat: not a reliable clinical sign in elderly patients.
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.
authors.affiliation: Department of Geriatric Medicine, St Woolos' Hospital, Newport, Gwent.
authors.forename: E
authors.initials: E
authors.lastname: Mulkerrin
authors.forename: R
authors.initials: R
authors.lastname: Saran
authors.forename: R
authors.initials: R
authors.lastname: Dewar
authors.forename: J R
authors.initials: JR
authors.lastname: Harding
authors.forename: A J
authors.initials: AJ
authors.lastname: Bayer
authors.forename: P
authors.initials: P
authors.lastname: Finucane
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006332:Cardiomegaly / Q000175:diagnosis*; D005260:Female; D006326:Heart Auscultation; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity