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A person can possibly visualise their heart beating in their chest around the area where the left 5th intercostal space (area between the 5th and 6th ribs), and the left mid-clavicular line (imaginary line drawn parallel to the body from the middle of the clavicle/collar-bone) meet.

This area is where one will visualise the apex beat of the heart, that is to say the further most point of the heart where the tip of the left ventricle is. The left ventricle is the largest room of the heart that pumps blood to the rest of the body. 

This visualisation can be disturbing for some, but it is important to note that it can commonly occur in thin people. If there are no other associated signs and symptoms present then is a normal or physiological occurence in this case.

One shouldn't worry about any abnormalities unless symptoms such as confusion, dizziness, shortness of breath or chest pains are experienced. Also, this situation would be regarded as a pathological issue if the position of the apex beat shifts more down and to the left or if the beating of the heart becomes more pronounced and the heart rate becomes irregular.

Should the above mentioned symptoms and signs be experienced, then it is suggested that you consult your primary care physician to perform an examination to see if further investigations are necessary and if a specialist referral to a cardiologist is warranted.

An EKG would be done to make sure that there are no signs of a heart attack, which would be due to decreased blood flow to the heart, as well as to help exclude any abnormal rythms of the heart. An echocardiogram, though, would best help to exclude any lesions of the valves of the heart and to make sure that the left ventricle has a normal size and shape. The latter will be the most important aspect to exclude as a cause of the visible heart beat.

Abnormalities of the left ventricle can include left ventricular hypertrophy. This is a condition where the left ventricle's muscle is thickened and this could be due to conditions such as uncontrolled hypertension (high blood pressure). The issue with this condition is that it can lead to heart failure because the contraction from this thickened muscle isn't optimal and can lead to fluid backup in the body. This isn't a permanent process fortunately, so with optimal treatment of the underlying issue, the thickened ventricle can reduce in size over time. 

This condition could cause a more pronounced and visible heart beat which may even be felt in larger individuals, but it still remains in the same position.

Another condition such as left ventricular dilatation, where the ventricle is dilated due to issues such as viral infections of the heart and alcohol abuse, will cause the apex beat to displaced. As mentioned above, the heart beat is felt further downwards and away from the normal position. This condition can also cause heart failure due to the contractility function of the heart being affected and may be managed by treating the underlying cause. 

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