Fourth Heart Sound Gallop 675 Lesson

patient thorax when auscultating by stethoscope

patient position during auscultation
The patient was supine during auscultation.

Description

In the recording, note that the fourth heart sound (S4) occurs in late diastole just before S1. The S1 intensity is decreased, while S2 intensity is increased. The fourth heart sound is low-pitched. Use the stethoscope bell, pressing lightly on the chest wall.

The fourth heart sound is generated by increased left ventricle stiffness due to scar tissue formation. This condition could be due to coronary heart disease.

Essential hypertension and aortic stenosis can also lead to fourth heart sounds. The anatomy animation video provides an example of S4.

Phonocardiogram

Anatomy

Fourth Heart Sound Gallop 675


Authors and Sources

Authors and Reviewers

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




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