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The third heart sound.

N Joshi1

  • 1Section of General Internal Medicine, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033, USA.

Southern Medical Journal
|August 24, 1999
PubMed
Summary
This summary is machine-generated.

The third heart sound (S3) can indicate left ventricular failure and predict surgical risks. However, its clinical use is limited by high variability in detection among healthcare providers.

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Area of Science:

  • Cardiology
  • Clinical Medicine
  • Diagnostic Physical Examination

Background:

  • Reevaluation of clinical utility of physical signs is timely in cost-effective healthcare.
  • The third heart sound (S3) is a physical sign warranting focused review.
  • Understanding S3's role in diagnosing cardiac conditions is crucial.

Purpose of the Study:

  • To review the clinical utility of the third heart sound (S3).
  • To assess S3 as an early indicator of left ventricular failure.
  • To evaluate S3's predictive value for surgical complications and treatment response.

Main Methods:

  • Computerized MEDLINE search for articles on S3 published since 1966.
  • Inclusion of pre-1966 information through textbook and cross-references.

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  • Systematic review of identified literature.

    • Main Results:

    • S3 can be an early sign of left ventricular failure.
    • S3 presence predicts high risk of postoperative complications in noncardiac surgery.
    • S3 predicts response to digoxin in congestive heart failure patients.
    • High interobserver variation in S3 detection exists, even among experts.

    Conclusions:

    • The third heart sound (S3) has significant clinical implications.
    • High interobserver variation in detecting S3 limits its widespread clinical application.
    • Further research may be needed to standardize S3 detection and interpretation.