Extra Heart Sounds (S3 and S4)

Summation Gallop at 120 beats per minute


At a heart rate of 120 beats per minute, the diastolic period is shortened. This causes the third and fourth sound to be superimposed, creating a single loud sound.

The anatomy tab shows an enlarged left ventricle with decreased left ventricular contractility and a minimally enlarged left atrium.

Summation Gallop at 120 beats per minute
maneuver image
Maneuver:Supine
Chestpiece Position:Mitral
Chestpiece:Diaphragm