For other parts of the cardiovascular exam, please refer to a textbook of physical examination. During inspection of the anterior chest, you should be looking for scars, obvious abnormalities, and the apical impulse. Tangential lighting will help you in visualizing impulses, but do not worry too much if you still cannot see them especially if the patient is particularly obese or muscular. These are best felt through the ball of your hand pressed firmly against the patient's chest. Thrills usually are associated with loud, harsh, or rumbling murmurs such as aortic stenosis or mitral stenosis.
Heaves often indicate right ventricular hypertrophy.
In women, you may find it helpful to ask the patient to displace her breast superiorly and laterally. Location of the apical impulse lateral and inferior to the 4th or 5th ICS along the MCL suggests an enlarged or displaced heart. An apical impulse is said to be sustained if it lasts longer than half of systole. Finally, notice if the amplitude of the apical impulse is increased, suggesting a hyperkinetic state eg hyperthyroidism, LV hypertrophy, after exercise. The pulmonic area is found in the 2nd ICS along the LSB which is over the pulmonary artery.