If the left ventricle is noncompliant, and atrial contraction forces blood through the atrioventricular valves, a S4 is produced by the blood striking the left ventricle. Therefore, any condition that creates a noncompliant LV will produce a S4, whereas any condition that creates an overly compliant LV will produce a S3 heart sound.
A S4 heart sound can be an important sign of diastolic heart failure or active ischemia and is rarely a normal finding. Diastolic heart failure frequently results from severe left ventricular hypertrophy, or LVH, resulting in impaired relaxation compliance of the LV.
This is a preview of subscription content, log in to check access. Used with permission and copyrighted by Laennec Publishing, Inc. All rights reserved MP4 kb. Vancheri F, Gibson D. Relation of third and fourth heart sounds to blood velocity during left ventricular filling. Br Heart J. Erikssen J, Rasmussen K. Although access to this website is not restricted, the information found here is intended for use by medical providers.
Patients should address specific medical concerns with their physicians. Toggle navigation. Cardiovascular Medicine. Examination Chapter.
To learn more about these, click here. Cardiovascular Physiology Concepts Richard E. Klabunde, PhD. Klabunde, all rights reserved Web Design by Jimp Studio. Normal in children; in adults, associated with ventricular dilation e.
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