- S3 is a low
intensity, low pitch sound
- Best heard with the bell
of your stethoscope pressed lightly on the apex
area of the heart.
- S3 created when the ventricles
relax and; pressure from the filling
blood rapidly
distends the ventricle.
- When the stiff,
non-compliant ventricular wall reaches
its physical limits, it suddenly tenses, and the S3 sound is created.
- In children
an S3 is common and normal.
- After age 40,
it almost always indicates the failing heart in congestive
heart failure.
- "Accentuated" rhythm below is at a
slow rate to facilitate learning.
- Most patients in failure will have rapid hearts.(CHF)
- Commonly accompanied by crackles in the patient
with CHF
- Less commonly S3 may be produced by conditions
causing volume overload of ventricles
- Aortic regurgitation, mitral regurgitation,
tricuspid regurgitation
- Patient with a heart failure typically has a tachycardia
to attempt to meet the bodies needs.
- "Accentuated" below shows an S3
gallop with a tachycardia
- Some liken the sound of an S3 to the syllables in
Ken-TUCK -y, Ken-TUCK-y, Ken-TUCK-y
- Others liken the sound to lub-dub-bub
where bub is soft
- S3 follows the S2
(vs S4 which precedes the S1)
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