Third and Fourth Heart Sound Gallop

In this lesson, we present a heart sound comprised of four components: S1, S1, S3 and S4. The third and fourth heart sounds (S3 and S4) are low frequency sounds with S4 lower than S3. This type of sound can be heard in improving heart failure patients. An S3 sound gives way to an S3 S4 pattern as the patient improves.


patient torso with stethoscope chestpiece
patient position during auscultation
The patient's position should be supine.



Authors and Reviewers

Authored by Thomas O Brien
. Medically reviewed by Dr. Jonathan Keroes, MD
Last Update: 11/8/2021
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