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Essential Heart Sounds

Fourth Heart Sound (S4) Gallop

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The fourth heart sound occurs in late diastole just before the first heart sound. When the fourth heart sound is present, the first heart sound is decreased and the second heart sound is increased in intensity. The fourth heart sound is created by an increased stiffness of the left ventricle, often caused by scar tissue formation. This may be a manifestation of coronary heart disease. A fourth heart sound can also be caused by a greatly thickened left ventricular wall such as with essential hypertension or aortic stenosis. Use the 'Visual' tab to see our animation of this type of fourth heart sound. The fourth heart sound is a low frequency sound best heard with the bell of the stethoscope pressed lightly on the skin of the chest. A fourth heart sound is never heard with atrial fibrillation because the contraction of the atria is ineffective in this condition.




Fourth Heart Sound (S4) Gallop
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Table of Contents

            Introduction
1Normal First and Second Heart Sounds - No Splitting
2Reduced Intensity First and Second Heart Sounds
3Split Second Heart Sound
4Third Heart Sound (S3) Gallop
lesson completed 5Fourth Heart Sound (S4) Gallop
6Third and Fourth Heart Sound Gallop
7Summation Gallop at 120 beats per minute
8Fixed Splitting of Second Heart Sound
9Mid-Systolic Click
10Systolic Murmur - Aortic Stenosis
11Diastolic Murmur - Aortic Regurgitation
12Mitral Valve Leaflet Prolapse
13Pansystolic Murmur - Mitral Regurgitation
14Diastolic Murmur - Mitral Stenosis

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Training Resources

More Heart Sounds

After this course, visit EasyAuscultation.com for additional heart sounds courses.

Learn More Heart Sounds »




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