Auscultation in Primary Care

Third and Fourth Heart Sound Gallop


Both the third and fourth heart sounds (S3 and S4) are low frequency. S4 is lower than S3.

This is a pattern that occurs with improvement of heart failure. That is, an S3 pattern gives way to an S3 S4 pattern as the patient improves.

Third and Fourth Heart Sound Gallop
maneuver image
Maneuver:Supine
Chestpiece Position:Mitral
Chestpiece:Bell