Med Student needs help with heart sounds - cardiomyopathy

[Brain Bucket]

Abnormal heart sounds in congestive (dilated) cardiomyopathy - Is it just S3 (with mitral/tricuspid regurg.) or is S4 present as well? TIA

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[Instatewaiter]

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.

 

[Brain Bucket]

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.

Thank you!

 

[dragonfly99]

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.