S3,S4 HEART SOUNDS

S3 heart sounds
Pathological cause
1. left ventricular failure
2.mitral regurgitation
3.in heart failure s3 occurs with tachycardia

Physiological causes- young adults, pregnancy, athelets, fever


S4 HEART SOUND-
It is soft , low pitched , best heard with bell of stethoscope at the apex . It is always pathological and is caused by forceful atrial contraction against  a non complaint or stiff ventricle

1. left ventricular hypertrophy( due to HTN, aortic stenosis, HOCM). It cannot occur in atrial fibrillation .

referral from MCLEOD