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S4 Heart Sound
Aka: S4 Heart Sound, S4 Gallop, S4 Gallup Rhythm, Fourth Heart Sound
- See Also
- Heart Auscultation
- S1 Heart Sound
- S2 Heart Sound
- S3 Heart Sound
- Heart Murmur
- Pediatric Murmur
- Pathophysiology
- S4 represents rapid active ventricular filling
- Occurs as atria contract during late diastole
- Outside of normal causes (see below), typically represents a stiff ventricle that resists dilation
- Associated with Ventricular Hypertrophy and Diastolic Dysfunction
- Signs
- S4, S1, S2 Sound like "Ten-ne-see" (dub-lub-dub)
- Causes
- Normal in athletes and the elderly
- Stiff Left Ventricle
- Hypertension
- Diastolic Dysfunction
- Coronary Artery Disease
- Aortic Stenosis
- Cardiomyopathy
- Ventricular Hypertrophy
- Resources
- University of Michigan Heart Sound and Murmur Library
- http://www.med.umich.edu/lrc/psb/heartsounds/