What is S4 Heart sound indicative of? S4 Heart Sound= Left Ventricular Hypertrophy, Low Compliance, Stiffness An audible S4 is abnormal in younger subjects and children; it is always abnormal when it is palpable, regardless of patient age. An abnormal S4 is most frequently observed in patients with decreased left ventricular distensibility. Thus, S4 is common in hypertensive heart disease, aortic stenosis, and hypertrophic cardiomyopathy. Left ventricular hypertrophy, which is present in all these conditions, contributes to decreased left ventricular distensibility. An S4 is heard in the vast majority of patients during the acute phase of myocardial infarction A loud S4 that is also usually palpable is a frequent finding in patients with acute and severe mitral or aortic regurgitation. It is almost always associated with an increased left ventricular end-diastolic pressure. If the patient is in atrial fibrillation, the atria are not contracting and it is impossible to have a S4 heart sound. S4 - atrial gallop Occurs in late diastole Occurs during active LV filling Almost always abnormal Requires a non-compliant LV Can be a sign of diastolic CHF Like S3, the S4 sound is low pitched and best heard at the apex with the patient in the left lateral decubitus position. Dr.S.H
Posted on: Tue, 06 Jan 2015 17:23:53 +0000
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