Third and fourth heart sound


This lesson contrasts two cycles. The first cycle has a split first heart sound and a split second heart sound. The second cycle has unsplit first and second heart sounds and both third and fourth heart sounds. A fourth heart sound is heard late in diastole, just before the next first heart sound. A fourth heart sound is an important indicator of poor ventricular function. A third heart sound has a rhythm similar to "Kentucky" and a fourth heart sound rhythm is similar to "Tennessee." A third heart sound has a slightly lower frequency than the first and second heart sounds. The fourth heart sound is even lower than the third. Both the third and fourth heart sounds (S3 and S4) are low frequency. S4 is lower than S3. This is a pattern that occurs with improvement of heart failure. That is, an S3 pattern gives way to an S3 S4 pattern as the patient improves.
Split First, Split Second HS
First, Second, Third, Fourth HS

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