Third and Fourth Heart Sound Gallop

Both the third and fourth heart sounds (S3 and S4) are low frequency. S4 is lower than S3. This is a pattern that occurs with improvement of heart failure. That is, an S3 pattern gives way to an S3 S4 pattern as the patient improves.

Third and Fourth Heart Sound Gallop Audio

Third and Fourth Heart Sound Gallop auscultation sound from lesson

Patient Sounds

Third and Fourth Heart Sound Gallop patient recording

Half Speed Patient Sounds

Third and Fourth Heart Sound Gallop half speed

Technique

The patient's position should be supine.

Auscultation Tips

Diastole:S3 and S4 present; galloping sound

Sound Wave

Observe Cardiac Animation

Authors and Sources

Authors and Reviewers

ECG heart rhythm modules: Thomas O'Brien.
ECG monitor simulation developer: Steve Collmann
12 Lead Course: Dr. Michael Mazzini, MD.
Spanish language ECG: Breena R. Taira, MD, MPH
Medical review: Dr. Jonathan Keroes, MD
Medical review: Dr. Pedro Azevedo, MD, Cardiology
Last Update: 11/8/2021

Sources

Electrocardiography for Healthcare Professionals, 6th Edition Kathryn Booth and Thomas O'Brien
ISBN10: 1265013470, ISBN13: 9781265013479
McGraw Hill, 2023
Rapid Interpretation of EKG's, Sixth Edition
Dale Dublin
Cover Publishing Company
EKG Reference Guide
EKG.Academy
12 Lead EKG for Nurses: Simple Steps to Interpret Rhythms, Arrhythmias, Blocks, Hypertrophy, Infarcts, & Cardiac Drugs
Aaron Reed
Create Space Independent Publishing
Heart Sounds and Murmurs: A Practical Guide with Audio CD-ROM 3rd Edition
Elsevier-Health Sciences Division
Barbara A. Erickson, PhD, RN, CCRN
The Virtual Cardiac Patient: A Multimedia Guide to Heart Sounds, Murmurs, EKG Jonathan Keroes, David Lieberman
Publisher: Lippincott Williams & Wilkin)
ISBN-10: 0781784425; ISBN-13: 978-0781784429
Project Semilla, UCLA Emergency Medicine, EKG Training Breena R. Taira, MD, MPH
ECG Reference Guide
PracticalClinicalSkills.com

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