What does displacement of cardiac apex towards left and downwards indicate?

Normal left ventricular apex Left ventricular hyperophy Right ventricular hyperophy Impulse is located at or medial to the left midclavicular line in the fouh or fifth intercostal space. The impulse may be displaced laterally and downward into the sixth or seventh intercostal space in cases of aoic regurgitation or lesions like aoic stenosis/HOCM. Results in a sustained systolic lift at the lower left parasternal area, which stas in early systole and is synchronous with the left ventricular apical impulse.