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.

After reviewing the sound, use the waveform and anatomy tabs for more information about this sound.

Third and Fourth Heart Sound Gallop
Position: Mitral
Maneuver: Supine
Chestpiece: Bell