Third and Fourth Heart Sound Gallop

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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
The recommended auscultation position for the stethoscope is the Mitral position. For this sound, use stethoscope's Bell.


maneuver
The recommended patient position is Supine

Phonocardiogram

waveform
This waveform plots sound amplitude on the vertical axis against time on the horizontal axis.

Heart Animation

Lessons
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Listening Tips
A synopsis of important sound features and timing for this abnormality.
Diastole: S3 and S4 present; galloping sound.
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