Auscultation in Primary Care

Third and Fourth Heart Sound Gallop C31

Virtual Auscultation

patient torso with stethoscope chestpiece

The patient's position should be supine.

Lesson

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.

Waveform

Heart Sounds Video

Authors and Reviewers

Authored by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient. Medically reviewed by Dr. Barbara Erickson, PhD, RN, CCRN. Last Update: 11/28/2021