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Related Experiment Videos

When does a fourth sound become an atrial gallop?

G L Perez, A A Luisada

    Angiology
    |May 1, 1976
    PubMed
    Summary

    This study investigated the fourth heart sound in healthy individuals and patients with heart conditions. A pathological fourth heart sound is indicated by increased magnitude and frequency, particularly in hypertension and coronary heart disease.

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    Area of Science:

    • Cardiology
    • Physiology

    Background:

    • The fourth heart sound (S4) is a presystolic sound that has been studied as both an auscultatory and graphic phenomenon.
    • Previous attempts to differentiate normal from pathological S4 sounds have lacked clear criteria.

    Purpose of the Study:

    • To investigate the characteristics of the fourth heart sound in normal subjects and patients with aortic stenosis, systemic hypertension, and coronary heart disease.
    • To establish more definitive criteria for identifying a pathological fourth heart sound.

    Main Methods:

    • Graphic recognition of the presystolic fourth heart sound using high-pass filters in 100 normal subjects and 42 patients.
    • Analysis of the incidence, magnitude, and vibrational frequency of the fourth heart sound.

    Main Results:

    • A pathological fourth heart sound was generally defined by a magnitude of at least 1/2 of the first heart sound or a frequency of 30 Hz.
    • Hypertension was associated with a higher incidence and magnitude of S4, especially in middle-aged individuals.
    • Coronary heart disease showed increased incidence, magnitude, and frequency of S4 compared to controls.

    Conclusions:

    • The combination of increased magnitude and frequency provides a significant indicator of a pathological fourth heart sound (gallop).
    • Specific patterns of S4 changes were observed in patients with hypertension and coronary heart disease, aiding in their diagnosis.

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