Extra Heart Sounds (S3 and S4)

Third and Fourth Heart Sound Gallop Sounds

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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.

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

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The recommended patient position is Supine

Phonocardiogram

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

Heart Animation

Lessons

1	Third Heart Sound Gallop
2	Fourth Heart Sound Gallop
3	Third and Fourth Heart Sound Gallop
4	Summation Gallop at 120 beats per minute

Practice Drill

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

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CourseID	25
CourseCaseOrder	3
ID	72