A nurse is examining an elderly patient who presents to the emergency department complaining of shortness of breath. The nurse notes a displaced point of maximal impulse (PMI) and a cardiac thrill. Which examination technique is the nurse using?

Palpating and noting the position of the point of maximal impulse (PMI) can assist in detecting cardiac enlargement. A normal PMI should be felt at the fifth intercostal space at the midclavicular line. A cardiac thrill is a palpable heart murmur that feels like a vibratory sensation on the skin noted directly over the area where there is turbulent blood flow through the heart.