Mastering S3 and S4 | Learn Third and Fourth Heart Sounds🫀

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Mastering S3 and S4 | Learn Third and Fourth Heart Sounds🫀

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▬▬▬▬▬▬▬▬▬▬ Contents of this video ▬▬▬▬▬▬▬▬▬▬

00:00:00 Introduction and brief review on first and second heart sounds S1 & S2
00:05:11 Genesis of 3rd Heart Sound (early diastole)
00:15:23 Diastasis
00:19:12 Genesis of 4th Heart Sound (late diastole, always pathological)
00:26:13 Recap
Pattern of sounds
00:27:58 S3 gallop, ventricular gallop, early diastolic gallop
00:29:14 b) S4 gallop, atrial gallop, late diastolic gallop
00:37:21 c) Quadruple gallop
00:40:10 d) Summation gallop
00:44:28 Causes of S3 heart sound
00:52:01 Causes of S4 heart sound
00:58:54 Review
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The third and fourth heart sound (S3 and S4) are two abnormal heart sound components which are proved to be indicators of heart failure during diastolic period. The combination of using diastolic heart sounds with the standard ECG as a measurement of ventricular dysfunction may improve the noninvasive diagnosis and early detection of myocardial ischemia.

Heart sounds are produced from a specific cardiac event such as closure of a valve or tensing of a chordae tendineae.

Many pathologic cardiac conditions can be diagnosed by auscultation of the heart sounds. Note that heart sounds are discrete, short audible events from a specific cause — different from a heart murmur. A murmur is due to turbulence of blood flow and can, at times, encompass all of systole or diastole.

The main normal heart sounds are the S1 and the S2 heart sound. The S3 can be normal, at times, but may be pathologic. A S4 heart sound is almost always pathologic. Heart sounds can be described by their intensity, pitch, location, quality and timing in the cardiac cycle.

Intensity: Heart sounds can be described as increased in intensity (loud), decreased in intensity (soft) or absent.

Pitch: Heart sounds can be described as high pitched (heard best with the diaphragm of the stethoscope).

Location: The location of the heart sound can help determine the etiology. The standard listening posts (aortic, pulmonic, tricuspid and mitral) apply to both heart sounds and murmurs. For example, the S1 heart sound — consisting of mitral and tricuspid valve closure — is best heard at the tricuspid (left lower sternal border) and mitral (cardiac apex) listening posts.
Timing: The timing can be described as during early, mid or late systole or early, mid or late diastole.

Although terms such as “click,” “snap” or “knock” are sometimes used, they have no specific quality or meaning. They will be referenced in the following sections.

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[sinisaass]

medicine student from Europe... was reading this from book for 30 minutes and had problem making diference between s3 and s4... u made it 100% clear to me... i know that now i udnerstand it fully which means i will prolly never forget it... sry for poor english... its not my main language :)

[Dilinaare]

Wonderfully explained. Thanking you on behalf of the millions of medical students you help on the daily.

[gojkomilikic]

Dr Najeeb, you're keeping medicine so crystal clear, logic and easy.
Beside that, you transmit your passion, evoke enthusiasm and keep motivation on the high level.
Thank you very much.

[PaulOBrienChina]

my dream is to command the concepts, theory and practice like Dr.Najeeb, a real role model !

[owaisali]

First time i cleared the concept of heart sounds and all this is possible bcoz of you ...may Allah shower his blessings upon you..love from india🇮🇳

[nangialayamalyar]

thank you very much Dr Najeeb I had big problem about S3 and S4 and further problem and now i know completely because of you
I pray for God to give you gift in this world and second world GOD BLESS YOU SIR

[arankalle]

The best "Doctor - Teacher" in the world currently !!

[gunasekarangunasekaran]

I never thought I could understand heart sounds even if I was taught with utmost patience.. Thank you so much Sir..

[nurjahankhatun]

Sir, I thoroughly enjoy listening to your lectures. You make it so simple. Best wishes.

[anuSharma-spcz]

Sir you are amazing .
Clearity of your concepts and the way you make our concepts is truly fantastic.

[nicolebsmithify]

God bless you immensely! This was beyond helpful and you have helped me achieve understanding which myself, other educators and classmates have failed to do. Thank you!

[shaikhjalilshaikhfarid]

I had never seen lecture like dr najeeb sir...I really impressed...

[chandrashekhartapashetti]

You are simply superb sir, beyond one's imagination, thanks to your infinite knowledge to clear doubts and create enthusiasm at basic level to understand concepts.

[maverickmckay]

Finally s3 and s4 make so much sense, I'll never forget it. Thank you so much sir.

[aliijaz]

Sir U r not only a Good Dr but a Professional teacher in real r m so so much great thankfull to have no words to express my feelings Allah bless

[ImranKhan-cgug]

Excellent ..I don't think even a cardiology professor could explain the way you explained sir..you ate next level..

[董柏辰-qt]

Thank you! You solved my question that confuse me so long time!
Your teaching is so clear and easy understanding!
Thank you again.

[SCI]

Doctor, I'm fom iraq and I'm really i don't see any doctor explain like you 🌸💌

[Mary-tigk]

Dr. Najeeb Sir You are simply the best teacher 👏👏 I have never learnt like this before. Your concept is crystal clear.

[Sanraa]

I don't know how to show my gratitude to you 👏👏👏👏I have been struggling with this topic for so long, but now everything is clear .thankyou thank-you so much sir 😘😘😘😘😘😘