S4 Heart Sounds Page

Welcome to our S4 heart sounds page. On this page we provide a definition and then we compare s4 heart sounds with a normal heart sounds and then s4 to s3, using audio recordings and text. Finally, there is a link to the training lessons available on this site.

What is an S4 Heart Sound?

Fourth heart sounds are low in frequency, occurring just before the first heart sound. It is best heard with the stethoscope's bell. The S4 heart sound creates a cadence which is like the word 'Tennessee', where the syllable 'Ten' is S4.

Normal vs S4 Heart Sound

Compare normal heart sounds vs S4 heart sounds.

Normal

Click to listen.

S4 Heart Sound

Listen for a short, low frequency sound early in diastole. Try to match the cadence to 'Tennessee'.









Compare a third heart sound (S3) to a fourth heart sound (S4).

S3 Heart Sound

Listen for a short, low frequency sound early in diastole. Try to match the cadence to 'Kentucky'.

S4 Heart Sound

Listen for a short, low frequency sound early in diastole. Try to match the cadence to 'Tennessee'.



Fourth Heart Sound Guide

Our auscultation guide provides information and examples of hearts sounds. For S4, the guide pages provide waveforms with a moving cursor that is synchronized to the audio recording. In addition, listening tips are available.
S4 Heart Sound





S4 Heart Sound Lesson

This is a link to our short course on extra heart sounds.
Extra Heart Sounds (S3 and S4)