Extra Heart Sounds (S3 and S4)

Third and Fourth Heart Sound Gallop Sounds

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.

CaseID	86
CourseID	25
CourseCaseOrder	3
ID	72