S4 Heart Sounds Introduction.

Introduction

Learn about the S4 heart sound, listen to examples, take short lessons and compare to other heart sounds. For all medical professionals.

Our S3 and S4 heart sound lessons can be found in this course. Secondly, our reference index is designed to provide quick access to stridor sounds, with audio tracks, listening guides and waveforms. Use this link for quick reference to heart and lung sounds.

What is an S4 Heart Sound?

Fourth heart sounds are low in frequency, occurring just before the first heart sound. It is best heard with the stethoscope's bell. The S4 heart sound creates a cadence which is like the word 'Tennessee', where the syllable 'Ten' is S4.

Listening Tips

Listen for a short, low frequency sound early in diastole. Try to match the cadence to 'Tennessee'.

Audio Playback

patient thorax when auscultating by stethoscope

The patient was supine during auscultation.

Waveform

Compare To S3

The patient was supine during auscultation.

Heart Sounds Reference Guide

Our auscultation reference guide provides quick access to this sound as well as many other adventitious sounds. Each sound is described also with an audio recording and waveform.

Heart Sounds Reference Guide

Authors and Reviewers

Heart sounds by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient.
Reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.
Last Update: 11/9/2021

Sources

Heart Sounds and Murmurs Across the Lifespan (with CD) Dr Barbara Ann Erickson
Publisher: Mosby
ISBN-10: 0323020453; ISBN-13: 978-0323020459
Heart Sounds and Murmurs: A Practical Guide with Audio CD-ROM 3rd Edition
Elsevier-Health Sciences Division
Barbara A. Erickson, PhD, RN, CCRN
How to measure blood pressure using a manual monitor
Mayo Foundation for Medical Education and Research (MFMER)
Heart and Lung Sounds Reference Guide
PracticalClinicalSkills.com
Manual Blood Pressure Measurement
Vital Sign Measurement Across the Lifespan