the normal position of the apex beat of the heart is the fifth intercostal space, medial to or at the midclavicular line
usually, this clinical location is slightly medial to the deeper anatomical apex of the heart
infants and children have apex beats which are superior and more lateral to those in adults
on palpation of the apex beat the examiner should attempt to judge if an enlarged heart is feeble (dilated) or stronger than usual (left or right ventricle hypertrophy or both)
Reference:
1) Kirby B (1993). Clinical examination of the heart. Medicine International, 21(8), 294-99.
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