HELP PLEASE!!! heart sounds and the cardiomyopathies

Discussion in 'Step I' started by bt9099, Jun 17, 2008.

  1. bt9099

    2+ Year Member

    Mar 30, 2008
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    Hi guys,

    I'm getting confused with the S3 and S4 heart sounds and their relationships to cardiac problems.

    So FA says that S3 is associate with dilated CHF, is this the same same dilated cardiomyopathy?

    Why would you get an S3 sound if the LV is dilated anyway---it happens at the end of rapid ventricular filling, but can anyone expalin why the sound appears?

    Thanks so much people, it is much appreciated!!!
  2. synapse lapse

    synapse lapse tokyo robotic
    15+ Year Member

    Mar 14, 2003
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    Attending Physician
    I will give it a shot, disclaimer that I am not a genius and may not know what the hell I am talking about. Dilated cardiomyopathy is dilation due to an external cause, such as toxin/infection. An S3 is heard as a result of a dilation (enlargement in volume area) of the ventricle. At the end of rapid filling, the blood "sloshes" as it hits the wall, making an S3 sound in early diastole. Imagine pouring water into a balloon - as the water rapidly ruses in, it sloshes and rumbles the wall of the balloon, but after some water is in there it just fills up. You would thus hear this sound in any condition that cases a dilation of the ventricle. An S4 is caused by the atrial kick pushing blood against a stiffened ventricle. This again causes a "rumble" as the chamber is full and unable to distend to accommodate the extra blood pushed by the atrial kick at end diastole. You should try and combine all your question threads into one.

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