S3 and S4 Heart sound - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 05-08-2013
npktun's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS+3
Posts: 297
Threads: 23
Thanked 312 Times in 144 Posts
Reputation: 322
Stethoscope S3 and S4 Heart sound

when you have s3 heart sound so that always mean you will have an s4 heart sound ....?

S3 --- occurs due to volume overload in the ventricles
S4----occurs due to decreased compliance ---> concentric hypertrophy and volume overload are responsible for it

But you can have an independent s4 heart sound ....

Am i messing something up ..... ?
__________________
256/262/passed/237/2016/need Visa/ 3 months USCE/ 1 Pub

To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message



  #2  
Old 05-08-2013
USMLE Forums Guru
 
Steps History: 1+CK+CS
Posts: 316
Threads: 17
Thanked 158 Times in 97 Posts
Reputation: 168
Default

S3 heart sound is also called ventricular gallop. It occurs due to the rapid ventricular filling against an already filled ventricle. Happens in CHF, in any pathology where blood isnt being pumped out from that ventricle effectively.

S4 heart sound happens just before the S1 (the atrioventricular valve closure). You can also call it atrial gallop, and its due to contraction of the atrium to eject that last amount of blood remaining in the atrium, but against a non-compliant ventricle. This usually happens in hypertrophied or stiff ventricles. To contrast, the S3 will happen when there is too much blood in the ventricle, and has nothing to do with the compliance of it.

Can someone else confirm?
Reply With Quote Quick reply to this message
The above post was thanked by:
Insomniac (05-09-2013), swwal (05-08-2013), whatsupdoc86 (05-08-2013)
  #3  
Old 05-08-2013
npktun's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS+3
Posts: 297
Threads: 23
Thanked 312 Times in 144 Posts
Reputation: 322
Default

Quote:
Originally Posted by medpack87 View Post
S3 heart sound is also called ventricular gallop. It occurs due to the rapid ventricular filling against an already filled ventricle. Happens in CHF, in any pathology where blood isnt being pumped out from that ventricle effectively.

S4 heart sound happens just before the S1 (the atrioventricular valve closure). You can also call it atrial gallop, and its due to contraction of the atrium to eject that last amount of blood remaining in the atrium, but against a non-compliant ventricle. This usually happens in hypertrophied or stiff ventricles. To contrast, the S3 will happen when there is too much blood in the ventricle, and has nothing to do with the compliance of it.

Can someone else confirm?

Goljan says so ..... look in heart disorders under heart sounds ..... compliance will be decreased in overload due to ventricles already dilated ....the muscle fibres already reached its maximal length so they would expand less exponentially with increasing force (here filling of blood ) ....analogy to rubberband already stretched may be suitable here ....it will stretch less and will require more force to stretch and we can say its compliance has decreased
__________________
256/262/passed/237/2016/need Visa/ 3 months USCE/ 1 Pub

To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
  #4  
Old 05-09-2013
USMLE Forums Guru
 
Steps History: 1+CK+CS
Posts: 316
Threads: 17
Thanked 158 Times in 97 Posts
Reputation: 168
Default

I do not have/read Goljan, so I cannot comment that. But for exam purposes, S3 = ventricle overload and S4= decreased ventricle compliance.
Reply With Quote Quick reply to this message
  #5  
Old 05-09-2013
npktun's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS+3
Posts: 297
Threads: 23
Thanked 312 Times in 144 Posts
Reputation: 322
Default

but apart from goljan .... dont you think increasing volume and dilating it will decrease compliance ...... as the muscle length increases don't you think the muscle will tend to expand less because its already stretched to its near to maximum length ..... ? and it will then take more force to expand (filling of blood) per unit increase of volume? what do you say ?
__________________
256/262/passed/237/2016/need Visa/ 3 months USCE/ 1 Pub

To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message



Reply

Tags
Audio-, Clinical-Signs

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Single Second Heart Sound S2 ag2011n USMLE Step 2 CK Forum 7 07-19-2013 08:09 PM
Single second heart sound and right ventricular prominence usmleman2020 USMLE Step 1 Forum 5 08-15-2011 07:25 PM
The mechanism of splitted second heart sound during inspiration! ricko335 USMLE Step 1 Forum 9 07-30-2011 09:44 AM
The heart sound in this lady! Prepping123 USMLE Step 1 Forum 5 04-10-2011 12:54 AM
The cause of this third heart sound? donofitaly USMLE Step 1 Forum 8 09-23-2010 03:05 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)