Fourth Heart Sound Plus First Heart Sound | #42

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.

Auscultation Audio

auscultation sound from lesson
waveform

Patient Sounds

patient heart or lung sound
Fourth Heart Sound Plus First Heart Sound

Half Speed Patient Sounds

patient heart or lung sound
Fourth Heart Sound Plus First Heart Sound

Technique

Patient position
The patient's position should be supine.

Auscultation Tips

Diastole:S4 present - a low-pitched sound

Sound Wave



Observe Cardiac Animation

Authors and Sources

Authors and Reviewers


Sources

Return to Reference Guide Index Page
Fourth Heart Sound Plus First Heart Sound | #42

Electrocardiogram (EKG/ECG) ECG Interpretation
Heart Sounds Heart Sounds
Lung Sounds Lung Sounds
Blood Pressure Blood Pressure
multimedia lessons Medical Terms
Ultrasound image Ultrasound
Electrocardiogram (EKG/ECG) EKG Rhythms
Pulmonary Problem-Solving Respiratory Care
multimedia lessons Basic ECG Monitor
Adv. ECG Monitor
Pulmonary Hypertension course image Fundamentals
Lung Sounds Key Lung Sounds
Pediatric referral image Pediatric Referral
Carotid Artery Bruit Carotid Bruit
Pulmonary Hypertension course image Pulmon. Hypertension
Abdominal Sounds Abdominal Sounds
Auscultation Training by Repetition Repetition Drill
auscultation guide torso

Reference Guide
multimedia lessons Free Resources
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