Heart Sounds Drill 1

Split S1 and S4

History

<p>This drill will teach you to tell the difference between a split first heart sound and a fourth heart sound. A fourth heart sound is heard just before the first heart sound and is lower in pitch (~60Hz) and shorter in duration. In this drill we will contrast a cycle with a split first heart sound and one with a fourth heart sound and an unsplit first heart sound. </p><p>Listen as long as you want. When you are confident that you can detect the difference, move on to the test. In the test we will play cycles randomly and ask you to tell which is which.</p>

Exam

Use the 'heart sounds' link above to virtually auscultate this patient.

Authors and Sources

Authors and Reviewers

Heart sounds by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient.
Lung sounds provided by Diane Wrigley, PA
Heart sounds mentorship by W. Proctor Harvey, MD
Reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.
Last Update: 11/10/2022

Sources

Heart Sounds and Murmurs Across the Lifespan (with CD) by 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
Heart and Lung Sounds Reference Guide
PracticalClinicalSkills.com
Heart Sounds Made Easy with CD-ROM: (with CD-ROM) 2nd Edition
Anthony P. Salmon
ISBN-13: 978-0443069079
NCBI Review of Heart Sounds and Murmurs: A Practical Guide
The Virtual Cardiac Patient: A Multimedia Guide to Heart Sounds And Murmurs Jonathan Keroes, David Lieberman
Publisher: Lippincott Williams & Wilkin)
ISBN-10: 0781784425; ISBN-13: 978-0781784429
Ventricular Function Curves in the Exercising Dog
JONATHAN KEROES , ROGER R. ECKER , and ELLIOT RAPAPORT
Circulation Research, Vol. 25, No. 5
Electrocardiographic changes associated with ritodrine-induced maternal tachycardia and hypokalemia American Journal of Obstetrics Gynecology, VOLUME 154, ISSUE 4, P921-923, APRIL 01, 1986
Susan K Hendricks, MD, Jonathan Keroes, MD, Michael Katz, MD
The_Virtual_Cardiac_Patient_A_Multimedia_Guide_to_Heart_Sounds_and_Murmurs A Multimedia Guide to Heart Sounds and Murmurs
January 2007 JAMA The Journal of the American Medical Association 297(2):217-218
DOI:10.1001/jama.297.2.217. M. Saleem Seyal, MD, Reviewer
Clinical Heart Disease W Proctor Harvey, MD