Which heart sound is a sign of pathology in an adult and occurs early in ventricular diastole during rapid ventricular filling?

Which heart sound is a sign of pathology in an adult and occurs early in ventricular diastole during rapid ventricular filling?

• A. S1
• B. S2
• C. S3
• D. S4

Answer: (C)

Abnormal ventricular filling sounds that appear early in diastole signal a ventricular gallop from rapid filling of a ventricle. This is S3. In adults, S3 is considered pathologic and points to raised filling pressures or volume overload, such as in heart failure or a dilated ventricle. It occurs just after the second heart sound during the rapid filling phase of diastole. When listening, it's best heard at the apex with the patient in the left lateral decubitus position using the bell, as a low-frequency sound that may feel like a brief, soft thud. S1 marks the start of systole with the closure of the mitral and tricuspid valves, S2 marks the end of systole with the closure of the aortic and pulmonic valves, and S4 is a late diastolic sound just before S1 caused by atrial contraction against a stiff ventricle.

Abnormal ventricular filling sounds that appear early in diastole signal a ventricular gallop from rapid filling of a ventricle. This is S3. In adults, S3 is considered pathologic and points to raised filling pressures or volume overload, such as in heart failure or a dilated ventricle. It occurs just after the second heart sound during the rapid filling phase of diastole. When listening, it's best heard at the apex with the patient in the left lateral decubitus position using the bell, as a low-frequency sound that may feel like a brief, soft thud.

S1 marks the start of systole with the closure of the mitral and tricuspid valves, S2 marks the end of systole with the closure of the aortic and pulmonic valves, and S4 is a late diastolic sound just before S1 caused by atrial contraction against a stiff ventricle.