Apexcardiography (ACG)

Norm of Apexcardiography (ACG)

Normal a wave, c point, e point, o point, rf wave, f point, sf wave, and stasis.

Cardiac Abnormalities Changes That May Be Found in Apexcardiographic Recording
Aortic valve stenosis Large a wave; apical impulse occurring late in systole
Atrial fibrillation Absent a wave; steepened slope of rf wave
Cardiac failure Apical impulse occurring late in systole
Coronary artery disease Apical impulse occurring late in systole
Mitral regurgitation Steepened slope of rf wave
Mitral stenosis Absent a wave; shallow slope of rf wave
Hypertension Large a wave; apical impulse occurring late in systole
Idiopathic hypertrophy Large a wave subaortic stenosis
Left ventricular aneurysm Apical impulse occurring late in systole
Myocardial ischemia or pericarditis Apical impulse occurring late in systole infarction; steepened slope of rf wave


Usage of Apexcardiography (ACG)

Helps diagnose heart abnormalities and arterial hypertension. In conjunction with phonocardiography, helps to identify heart sounds.


Description of Apexcardiography (ACG)

Apexcardiography is a method to transfer cardiac movement and pulsations into electrical energy by a transducer and produce a graphic recording of waveforms that characterize the status of the heart. The test takes less than ½ hour to perform.


Professional Considerations of Apexcardiography (ACG)

Consent form NOT required.

  1. Remove jewelry and any metal objects.
  2. The client should disrobe above the waist.



  1. The client is placed in a left oblique position, and electrocardiographic limb leads are applied. The transducer tip, covered with electroconductive gel, is strapped in place in contact with the point of maximum impulse at the apex of the heart.
  2. Apexcardiographic recordings are made as the client lies motionless and performs isometric hand-clenching exercises, which increase systemic vascular resistance.


Postprocedure Care

  1. Remove transducer and limb leads. Cleanse the electroconductive gel off the transducer and off the client's chest.


Client and Family Teaching

  1. The test is painless.
  2. Slow, even respirations promote the most accurate test results. You should not talk or move during the procedure.
  3. You will be asked to isometrically clench your fists, which means clenching them and then squeezing them and holding them tightly shut.


Factors That Affect Results

  1. Implantable metal devices in the chest wall, such as venous access devices, do not interfere with the test as long as leads are not placed directly over the metal device.


Other Data

  1. This test is rarely used due to the availability of echocardiogram and nuclear medicine testing.