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Fourth Heart Sound Gallop Lesson

Virtual Auscultation

patient torso with stethoscope chestpiece

patient position during auscultation
The patient's position is supine.

Lesson

In the recording, note that the fourth heart sound (S4) occurs in late diastole just before S1. The S1 intensity is decreased, while S2 intensity is increased. The fourth heart sound is low-pitched. Use the stethoscope bell, pressing lightly on the chest wall.

The fourth heart sound is generated by increased left ventricle stiffness due to scar tissue formation. This condition could be due to coronary heart disease.

Essential hypertension and aortic stenosis can also lead to fourth heart sounds. The anatomy animation video provides an example of S4.

Waveform




Heart Sounds Video



Authors and Sources

Authors and Reviewers

Sources

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