Med Student needs help with heart sounds - cardiomyopathy

In a volume overloaded patient you can usually hear an S3.

You can have an S4 as well. An S4 just signifies a stiff ventricle. Most people with longstanding hypertension will have an S4. Also in various forms of cardiomyopathy the ventricle will be hypertrophied and stiff, causing an S4.

s4 can be really hard to hear, b/c it's low pitched usually.
tricuspid regurgitation shoudl be a systolic murmur along L sternal border usually, and MR can be at apex radiating to axilla, but sometimes you can heart it other places like radiating to L sternal border or all over the precordium/heart area.