What correlates with a sustained, high-amplitude PMI?

A sustained, high-amplitude point of maximal impulse (PMI) correlates with increased left ventricular workload and is often observed in conditions that lead to left ventricular hypertrophy. In this context, hypertension is significant because it increases systemic vascular resistance, resulting in the heart needing to work harder to pump blood, which can lead to hypertrophy of the left ventricle.

This hypertrophy causes the PMI to become more prominent and sustained, manifesting as a high-amplitude impulse on physical examination. Other conditions, like hyperthyroidism or anemia, might influence heart rate and cardiac output but do not typically produce the same sustained, high-amplitude PMI. Fever can increase heart rate and cardiac output as well, but again does not correlate with the sustained, high-amplitude characteristics seen with left ventricular hypertrophy due to hypertension. Thus, the relationship between hypertension and a sustained, high-amplitude PMI is well established in the context of the heart's adaptation to increased workload.