Split S1 and S4


It is no secret that a certain heart sound configurations mimic a split first heart sound. One of these conditions is a fourth sound gallop (S4) plus a first heart sound (S1). Since the S4 occurs just before the S1 it is easy to confuse a S4/S1 with a split S1. An S4 is lower frequency than an S1. To differentiate between a S4/S1 and a split S1, listen carefully to the frequency of the initial sound of the pair. If it is lower in frequency than the second sound it is an S4. If the two sounds are the same it is a split S1. The main purpose of this lesson to learn to hear the difference between Split First Heart Sound and Fourth Heart Sound
Split First Heart Sound
Fourth Heart Sound Present

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