Northwestern University Feinberg School of Medicine

Extra heart sound — S3 vs S4

A 72-year-old man with long-standing hypertension has two months of worsening shortness of breath on exertion. On auscultation there is an extra low-pitched sound in diastole. Is it an S3 or an S4?

Differential: S3 gallop or S4 gallop

Pick a tool and click the manikin.Tool: none · Position: Supine
← sternal angleMCLPatient's RPatient's L

Tools

Pick a tool, then click where you would use it on the manikin.

Patient position

These steps aren't on the body diagram. Click a button to perform one.

Off the chest diagram

Special tests