S4 Heart Sounds Introduction

Introduction

Learn about the S4 heart sound, listen to examples, take short lessons and compare to other heart sounds. For all medical professionals.

Our S3 and S4 heart sound lessons can be found in this course.. Secondly, our reference index is designed to provide quick access to stridor sounds, with audio tracks, listening guides and waveforms. Use this link for quick reference to heart and lung sounds.

What is an S4 Heart Sound?

Fourth heart sounds are low in frequency, occurring just before the first heart sound. It is best heard with the stethoscope's bell. The S4 heart sound creates a cadence which is like the word 'Tennessee', where the syllable 'Ten' is S4.



Listening Tips

Listen for a short, low frequency sound early in diastole. Try to match the cadence to 'Tennessee'.

Audio Playback

patient torso with stethoscope chestpiece
patient position during auscultation
The patient's position should be supine.

Waveform

static waveform for 76

Visualize

static waveform for 76


Compare To S3

patient torso with stethoscope chestpiece
patient position during auscultation
The patient's position should be supine.

Heart Sounds Reference Guide

Our auscultation reference guide provides quick access to this sound as well as many other adventitious sounds. Each sound is described also with an audio recording and waveform.

Quick Links to Other Breath Sounds

While we have many breath sound lessons and quick references on this website. Please use the links below.



Related Lessons


Basics of Lung Sounds
The goal of this basic course in lung sounds is to improve auscultation observational skills. We focus on describing important breath sounds and in providing recordings of each. Many students find that waveform tracings aid in learning lung sounds; we have included dynamic (moving cursor) waveforms with each lesson. The anatomy pages use illustrations to reveal an example of each lung sound (anatomy not yet available on smartphones).
Lesson List
1 Vesicular - Normal
2 Crackles - Fine (Rales)
3 Crackles - Coarse (Rales)
4 Wheeze
5 Rhonchi - Low Pitched Wheezes
6 Bronchial
7 Pleural Rubs
8 Bronchovesicular
Intermediate Lung Sounds
The goal of this intermediate course is to expand your observational skills when auscultating breath sounds. The course lessons include voiced sounds: bronchophony, egophony and whispered pectoriloquy. We also provide auscultation lessons on several types of wheezes, crackles and stridor. Each of these lung sound lessons includes audio, text and dynamic waveform. The anatomy pages use illustrations to reveal an example of each lung sound (anatomy not yet available on smartphones).
Lesson List
1 Vesicular - Diminished
2 Bronchophony - Healthy
3 Bronchophony - Abnormal
4 Egophony - e
5 Egophony - a
6 Whispered Pectoriloquy - Healthy
7 Whispered Pectoriloquy - Abnormal
8 Wheeze - Expiratory
9 Wheeze - Monophonic
10 Wheeze - Polyphonic
11 Crackles - Early Inspiratory (Rales)
12 Crackles - Late Inspiratory (Rales)
13 Stridor


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