Sign in or Join to use this module.

Fourth Heart Sound Gallop

Fourth Heart Sound Gallop

The fourth heart sound occurs in late diastole just prior to the first heart sound. The first heart sound is decreased in intensity and the second heart sound is increased in intensity. The fourth heart sound is produced by an increase in stiffness of the left ventricle due to scar tissue formation. This may be a manifestation of coronary heart disease. A fourth heart sound can also be caused by a greatly thickened left ventricular wall such as with essential hypertension or aortic stenosis. This is shown in the anatomy video. A fourth heart sound is never heard with atrial fibrillation because the contraction of the atria is ineffective in this condition. The fourth heart sound is a low frequency sound best heard with the bell of the stethoscope pressed lightly on the skin of the chest.


Auscultation Sounds

auscultation sound from lesson
waveform





Position

Patient position
The patient's position should be supine.

Listening Tips

S1:Reduced intensity
S2:Increased intensity
Diastole:S4 present - a low-pitched sound


Waveform (Phonocardiogram)

Observe

//embedding heart animation

Authors

These authors contributed the audio recordings and text found in this reference guide: Jon Keroes, MD,Diane Wrigley, PA, and David Lieberman.
Medically reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.

Sources


Sources




Return to Reference Guide Index Page



An error has occurred. This application may no longer respond until reloaded. Reload 🗙