Exam
S4 Heart Sound
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S4 Heart Sound
, S4 Gallop, S4 Gallup Rhythm, Fourth Heart Sound
Signs
S4, S1, S2 Sound like "Ten-ne-see" (dub-lub-dub)
Causes
Normal in athletes and the elderly
Stiff Left Ventricle
Hypertension
Coronary Artery Disease
Aortic Stenosis
Cardiomyopathy
Resources
University of Michigan Heart Sound and Murmur Library
http://www.med.umich.edu/lrc/psb/heartsounds/
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