*In children, which is more likely to be abnormal–a 3rd heart sound (S3) or a 4th heart sound (S4)? What is this heart sound associated with?
S4An S3 can be normal in children, but an S4 is almost always abnormal in children. An S4 can be heard with aortic stenosis, mitral regurgitation, hypertrophic cardiomyopathy, and hypertension with left ventricular hypertrophy.
In children, a 3rd heart sound (S3) is more likely to be abnormal than a 4th heart sound (S4).
A third heart sound (S3) is also known as a ventricular gallop. It is associated with rapid filling of the ventricle during the early diastolic phase of the cardiac cycle. In children, S3 may be an early sign of heart failure or cardiomyopathy.
A fourth heart sound (S4) is also known as an atrial gallop. It is associated with stiff ventricular walls and decreased ventricular compliance during the late diastolic phase of the cardiac cycle. S4 is a common finding in older adults and can be a sign of underlying heart disease, such as hypertension or coronary artery disease. It is less likely to be abnormal in children.
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