Fourth and First Heart Sounds Lesson
The patient was supine during auscultation.
Description
A fourth sound gallop (S4) plus a first heart sound (S1) can mimic a split first heart sound. Since the S4 occurs just before the S1, it is easy to confuse a S4-S1 pair with a split S1.
Listen carefully to the frequency of the initial sound of the S4-S1 pair. If it is lower in frequency than the second sound, it is an S4. If the two sounds have a similar frequency, it is a split S1.
Phonocardiogram
Anatomy
Fourth and First Heart Sounds
Authors and Sources
Authors and Reviewers
-
Heart sounds by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient.
- Lung sounds by Diane Wrigley, PA
- Respiratory cases: William French
-
David Lieberman, Audio Engineering
-
Heart sounds mentorship by >W. Proctor Harvey, MD
- Special thanks for the medical mentorship of Dr. Raymond Murphy
- Reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.
-
Last Update: 11/10/2021
Sources
-
Heart and Lung Sounds Reference Library
Diane S. Wrigley
Publisher: PESI -
Impact Patient Care: Key Physical Assessment Strategies and the Underlying Pathophysiology
Diane S Wrigley & Rosale Lobo - Practical Clinical Skills: Lung Sounds
- PESI Faculty - Diane S Wrigley
-
Case Profiles in Respiratory Care 3rd Ed, 2019
William A.French
Published by Delmar Cengage -
Essential Lung Sounds
by William A. French
Published by Cengage Learning, 2011 -
Understanding Lung Sounds
Steven Lehrer, MD
-
Clinical Heart Disease
W Proctor Harvey, MD
Clinical Heart Disease
Laennec Publishing; 1st edition (January 1, 2009) -
Heart and Lung Sounds Reference Guide
PracticalClinicalSkills.com
