S4 Gallop
S4 Gallop - Related Videos
10:51
Cardiac Exam III: Abnormal Heart Sounds
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2023
Source: Suneel Dhand, MD, Attending Physician, Internal Medicine, Beth Israel Deaconess Medical Center Having a fundamental understanding of normal heart sounds is the first step toward distinguishing the normal from the abnormal. Murmurs are sounds that represent turbulent and abnormal blood flow across a heart valve. They are caused either by stenosis (valve area too narrow) or regurgitation (backflow of blood across the valve) and are commonly heard as a "swishing" sound during auscultation.
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Cardiac Exam II: Auscultation
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2023
Source: Suneel Dhand, MD, Attending Physician, Internal Medicine, Beth Israel Deaconess Medical Center Proficiency in the use of a stethoscope to listen to heart sounds and the ability to differentiate between normal and abnormal heart sounds are essential skills for any physician. Correct placement of the stethoscope on the chest corresponds to the sound of cardiac valves closing. The heart has two main sounds: S1 and S2. The first heart sound (S1) occurs as the mitral and tricuspid valves...
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Kinematics and Ground Reaction Force Determination: A Demonstration Quantifying Locomotor Abilities of Young Adult, Middle-aged, and Geriatric Rats
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Cited by 26 •
2011
Locomotion is often examined as a behavioural outcome in various models of disease in fields such as neuroscience and orthopedics. This video paper intends to describe a method for collecting ground reaction forces and kinematics from rats during unrestrained locomotion.
03:34
Establishing a Whole-Cell Patch Clamp for Electrophysiological Recording from Vomeronasal Sensory Neurons
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2025
The protocol video describes establishing a whole-cell patch clamp for electrophysiological recording from the sensory neurons of the vomeronasal organ (VNO) in mice. A coronal VNO slice with fluorescently labeled sensory neurons is placed in a recording setup. A labeled neuron is patched with a recording pipette in a whole-cell configuration for electrophysiological recording in response to chemical stimuli.
06:17
Auscultation
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2023
Source: Jaideep S. Talwalkar, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT Through auscultation, the clinician is able "to eavesdrop on the workings of the body" to gain important diagnostic information.1 Historically, the term "auscultation" was synonymous with "immediate auscultation," in which the examiner's ear was placed directly against the patient's skin. Although this was standard practice for centuries, the method proved inadequate in nineteenth-century...
FAQs
Its timing reflects the role of atrial contraction in ventricular filling. Near the end of diastole, the atrium pushes blood into the ventricle, and the resulting interaction with a stiff ventricular chamber produces vibrations. This late timing helps distinguish the finding as a marker of impaired ventricular relaxation and filling rather than an abnormality occurring during ventricular contraction.
A ventricle with reduced compliance does not accommodate incoming blood easily during atrial contraction. The atrial push against this stiff chamber generates vibrations that can be heard during auscultation. Thus, the sound provides an acoustic clue to increased ventricular stiffness and helps connect a bedside finding with altered diastolic ventricular function.
Long-standing hypertension, left ventricular hypertrophy, and myocardial ischemia are commonly associated with this finding. Although these conditions differ clinically, the overview connects them with a ventricle that may become less compliant. Detecting the sound therefore raises concern for an underlying cardiovascular process affecting ventricular stiffness or diastolic filling.
An S4 gallop suggests that ventricular filling is occurring against increased chamber stiffness. It can therefore indicate impaired diastolic filling and reduced ventricular compliance, offering information that may not be apparent from symptoms alone. In clinical assessment, this finding contributes to evaluation of ventricular function and supports consideration of underlying cardiovascular disease.
The sound is best assessed with the bell of a stethoscope placed near the cardiac apex. Because S4 is low frequency and occurs late in diastole, careful attention to the timing and quality of sounds is important. This focused auscultation approach supports bedside recognition of a possible abnormality in ventricular compliance and filling.
The bell is preferred because S4 Gallop is a low-frequency sound. Positioning it near the cardiac apex helps the examiner assess vibrations associated with atrial contraction entering a stiff ventricle. Using this focused technique improves the opportunity to recognize the finding during routine cardiac auscultation and relate it to suspected diastolic dysfunction.
Recognizing an S4 gallop adds bedside evidence of increased ventricular stiffness and impaired diastolic filling. In the context of conditions such as hypertension, left ventricular hypertrophy, or myocardial ischemia, it can prompt further evaluation of the underlying cardiovascular disease. The finding therefore helps connect physical examination results with assessment of ventricular function.