Additional Heart Sounds—Part 1 (Third and Fourth Heart Sounds)

  title={Additional Heart Sounds—Part 1 (Third and Fourth Heart Sounds)},
  author={Ramya Pechetty and Lalita Nemani},
S3 is a low-pitched sound (25–50Hz) which is heard in early diastole, following the second heart sound. The following synonyms are used for it: ventricular gallop, early diastolic gallop, protodiastolic gallop, and ventricular early filling sound. The term “gallop” was first used in 1847 by Jean Baptiste Bouillaud to describe the cadence of the three heart sounds occurring in rapid succession. The best description of a third heart sound was provided by Pierre Carl Potain who described an added… 


The Genesis of Gallop Sounds: Investigation by Quantitative Phono‐ and Apexcardiography
The data suggest that the higher intensity of gallop sounds and the higher dP/dt of the filling waves over the chest cannot be caused by passive transmission of sound or pressure changes in the left ventricle, and postulate that the greater vibratory energy ofgallop sounds recorded over the precordium is caused by the impact of the heart on the chest wall.
Investigation of genesis of gallop sounds in dogs by quantitative phonocardiography and digital frequency analysis.
The absence of internal gallop sounds of expected amplitude as calculated from the externalgallop sounds and the gain function derived from the comparison of internal and external S1 make it very unlikely that external gallopSounds are derived from internal sounds.
Origin of the Third Heart Sound: II. Studies in Human Subjects
The concept that the S3 is due to a sudden intrinsic limitation of longitudinal expansion of the left ventricular wall during early diastolic filling, resulting in a negative jerk that is transmitted to the skin surface is supported.
Relationship of the fourth heart sound to atrial systolic transmitral flow deceleration.
It is concluded that, with a normal mitral valve, there should always be an oscillation of the cardiohemic system during A-wave deceleration, however, oscillations may not have high enough amplitude, frequency, or coupling to the chest wall to be clinically audible as an S4.
Audibility of the fourth heart sound. A prospective, "blind" auscultatory and polygraphic investigation.
Results of this investigation indicate that any tendency for rapid completion of atrial excitation and early onset of S 4 appears to determine the auscultatory audibility of the fourth heart sound.
Heart sounds in atrial flutter-fibrillation.
Physiologic Principles of Heart Sounds and Murmurs
This symposium has been developed with the express purpose of providing medical educators and students with a detailed physiologic understanding of the principles underlying the major cardiac acoustic events, whether normal or pathologic, and it succeeds admirably.
Relationship of the third heart sound to transmitral flow velocity deceleration.
It is concluded that, in the presence of a normal mitral valve, the kinematics of filling requires that all hearts have oscillations of the cardiohemic system during E-wave deceleration, but the oscillations may not have high enough amplitude or frequency to be heard as an S3 unless there is sufficiently rapid fluidDeceleration of the Doppler E- wave contour.