The external chest has normal appearance without thrills, lifts or heaves. The chest wall rises symmetrically with respirations. There is no jugular venous distention or chest scars. The client does not have a pigeon chest or sunken sternum. The point of maximum impulse is at 5th intercostal space in the left midclavicular line. The pulses are adequate in peripheries and centrally. On auscultation, there is no thrill or adventitious heart sounds. There is no palpitation or murmurs.
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