Toggle Menu
Heart
Heart Sounds Introduction
Pediatrics: When To Refer
Heart Murmur
Normal Heart Sounds
First Heart Sounds
Second Heart Sounds
Extra Heart Sounds (S3 & S4)
Systolic Murmurs
Diastolic Murmurs
Complex Conditions
Congenital Abnormalities
Cardiac Conditions Assoc. with Sudden Death
Heart Sounds in Primary Care
Auscultation Repetition Training
Heart Sounds Guide
Lungs
Lung Sounds Introduction
Basic Lung Sounds
Intermediate Lung Sounds
Lung Sounds Guide
BP
Taking Blood Pressure
Measuring Blood Pressure Procedure
Adult Case Studies Part I
Adult Case Studies Part II
High Blood Pressure in Children
Extras
Quizzes
Heart Sounds Guide
Lung Sounds Guide
Sonography Training (free)
About
About
Advertise
Blog
Medical Terms
Terms
Blog
Sign In
First Heart Sounds
Fourth Heart Sound Plus First Heart Sound
Certain heart sound configurations mimic a split first heart sound.
One of these conditions is a fourth sound gallop (S4) plus a first heart sound (S1). Since the S4 occurs just before the S1 it is easy to confuse a S4/S1 with a split S1.
An S4 is lower frequency than an S1. To differentiate between a S4/S1 and a split S1, listen carefully to the frequency of the initial sound of the pair. If it is lower in frequency than the second sound it is an S4. If the two sounds are the same it is a split S1.
play
pause
Position:
Mitral
Chestpiece:
Bell
Maneuver:
Supine
Phonocardiogram
Heart Animation
Table of Contents
1
First Heart Sound - Loud
2
First Heart Sound (Minimally Split)
3
First Heart Sound (Markedly Split)
4
First Heart Sound - Decreased Intensity
5
Fourth Heart Sound Plus First Heart Sound
6
First Heart Sound plus Aortic Ejection Click
Practice Drill