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Tapping apex beat

Apex beat is of low amplitude
It is ill sustained occur in mitral stenosis and tachycardia
Palpating finger is not lifted, the distinct palpable shock of accentuated first heart sound is felt as tap by which the apex beat is located.
Mechanism of tapping apex beat
Tapping apex beat is present only in mitral stenosis where the leftventricular size and filling is less. Apical impulse produced by the leftventricle is less which cannot be felt by the palpating finger, instead the accentuated 1st heart sound produced at the mitral valve is transmitted  to the apex and give the feel of tap. Later,Pulmonary artery hypertension ( PAH )and RV enlargement produces clockwise rotation of the heart pushing the LV further posteriorly, hence  further impeding the forward movement of the anatomical apex
Cause of tapping apex beat
Mitral stenosis