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Fourth heart sound

MedGen UID:
604154
Concept ID:
C0425593
Finding
Synonym: Presystolic gallop
SNOMED CT: Fourth sound gallop (4592006); S>4< gallop (4592006); Atrial gallop (4592006)
 
HPO: HP:0031659

Definition

The fourth heart sound (S4) is a low-pitched sound that occurs just before the first heart sound (S1) when the atria contract to force blood into the left ventricle, that is, coincident with late diastolic filling of the ventricle due to atrial contraction. [from HPO]

Term Hierarchy

Conditions with this feature

Myopathy, myosin storage, autosomal recessive
MedGen UID:
340603
Concept ID:
C1850709
Disease or Syndrome
Autosomal recessive myosin storage congenital myopathy-7B (CMYP7B) is a skeletal muscle disorder characterized by the onset of scapuloperoneal muscle weakness in early childhood or young adulthood. Affected individuals have difficulty walking, steppage gait, and scapular winging due to shoulder girdle involvement. The severity and progression of the disorder is highly variable, even within families. Most patients develop respiratory insufficiency, nocturnal hypoventilation, and restrictive lung disease; some develop hypertrophic cardiomyopathy. Additional features include myopathic facies, high-arched palate, scoliosis, and muscle wasting with thin body habitus. Serum creatine kinase may be normal or elevated. Skeletal muscle biopsy shows variable findings, including myosin storage disease, type 1 fiber predominance, centralized nuclei, and multiminicore disease (Onengut et al., 2004; Tajsharghi et al., 2007; Beecroft et al., 2019). For a discussion of genetic heterogeneity of congenital myopathy, see CMYP1A (117000).

Professional guidelines

PubMed

Senni M, Rodeheffer RJ, Tribouilloy CM, Evans JM, Jacobsen SJ, Bailey KR, Redfield MM
J Am Coll Cardiol 1999 Jan;33(1):164-70. doi: 10.1016/s0735-1097(98)00523-3. PMID: 9935024

Recent clinical studies

Etiology

Sakai C, Kawasaki T, Kawamata H, Harimoto K, Shiraishi H, Matoba S
Ann Noninvasive Electrocardiol 2022 May;27(3):e12932. Epub 2022 Feb 11 doi: 10.1111/anec.12932. PMID: 35146850Free PMC Article
Tsai HJ, Tsai YC, Huang JC, Wu PY, Chen SC, Chiu YW, Chang JM, Chen HC
Dis Markers 2019;2019:5270159. Epub 2019 Nov 5 doi: 10.1155/2019/5270159. PMID: 31781303Free PMC Article
Gupta S, Michaels AD
Clin Cardiol 2009 Feb;32(2):69-75. doi: 10.1002/clc.20431. PMID: 19215005Free PMC Article
Shah SJ, Nakamura K, Marcus GM, Gerber IL, McKeown BH, Jordan MV, Huddleston M, Foster E, Michaels AD
J Card Fail 2008 Jun;14(5):431-6. Epub 2008 May 27 doi: 10.1016/j.cardfail.2008.01.010. PMID: 18514937Free PMC Article
Mittal SR, Pamecha S, Rohatgi R, Saxena R, Gokhroo R
Int J Cardiol 1992 Aug;36(2):187-96. doi: 10.1016/0167-5273(92)90006-o. PMID: 1512057

Diagnosis

Shitara J, Kasai T, Murata N, Yamakawa N, Yatsu S, Murata A, Matsumoto H, Kato T, Suda S, Matsue Y, Naito R, Hiki M, Daida H
ESC Heart Fail 2021 Oct;8(5):4037-4047. Epub 2021 Jun 28 doi: 10.1002/ehf2.13492. PMID: 34184415Free PMC Article
Tsai HJ, Tsai YC, Huang JC, Wu PY, Chen SC, Chiu YW, Chang JM, Chen HC
Dis Markers 2019;2019:5270159. Epub 2019 Nov 5 doi: 10.1155/2019/5270159. PMID: 31781303Free PMC Article
Tseng YL, Ko PY, Jaw FS
Biomed Eng Online 2012 Feb 14;11:8. doi: 10.1186/1475-925X-11-8. PMID: 22332995Free PMC Article
Gupta S, Michaels AD
Clin Cardiol 2009 Feb;32(2):69-75. doi: 10.1002/clc.20431. PMID: 19215005Free PMC Article
Mittal SR, Pamecha S, Rohatgi R, Saxena R, Gokhroo R
Int J Cardiol 1992 Aug;36(2):187-96. doi: 10.1016/0167-5273(92)90006-o. PMID: 1512057

Therapy

Sakai C, Kawasaki T, Kawamata H, Harimoto K, Shiraishi H, Matoba S
Ann Noninvasive Electrocardiol 2022 May;27(3):e12932. Epub 2022 Feb 11 doi: 10.1111/anec.12932. PMID: 35146850Free PMC Article
Tsai HJ, Tsai YC, Huang JC, Wu PY, Chen SC, Chiu YW, Chang JM, Chen HC
Dis Markers 2019;2019:5270159. Epub 2019 Nov 5 doi: 10.1155/2019/5270159. PMID: 31781303Free PMC Article
Gupta S, Michaels AD
Clin Cardiol 2009 Feb;32(2):69-75. doi: 10.1002/clc.20431. PMID: 19215005Free PMC Article
Senni M, Rodeheffer RJ, Tribouilloy CM, Evans JM, Jacobsen SJ, Bailey KR, Redfield MM
J Am Coll Cardiol 1999 Jan;33(1):164-70. doi: 10.1016/s0735-1097(98)00523-3. PMID: 9935024
Mittal SR, Pamecha S, Rohatgi R, Saxena R, Gokhroo R
Int J Cardiol 1992 Aug;36(2):187-96. doi: 10.1016/0167-5273(92)90006-o. PMID: 1512057

Prognosis

Wang W, Hao H, Fan T, Yue J, Wang M, Chen M, Deng G, Si L, Zhang F
Sci Rep 2023 May 3;13(1):7192. doi: 10.1038/s41598-023-34370-x. PMID: 37137970Free PMC Article
Sakai C, Kawasaki T, Kawamata H, Harimoto K, Shiraishi H, Matoba S
Ann Noninvasive Electrocardiol 2022 May;27(3):e12932. Epub 2022 Feb 11 doi: 10.1111/anec.12932. PMID: 35146850Free PMC Article
Shitara J, Kasai T, Murata N, Yamakawa N, Yatsu S, Murata A, Matsumoto H, Kato T, Suda S, Matsue Y, Naito R, Hiki M, Daida H
ESC Heart Fail 2021 Oct;8(5):4037-4047. Epub 2021 Jun 28 doi: 10.1002/ehf2.13492. PMID: 34184415Free PMC Article
Tsai HJ, Tsai YC, Huang JC, Wu PY, Chen SC, Chiu YW, Chang JM, Chen HC
Dis Markers 2019;2019:5270159. Epub 2019 Nov 5 doi: 10.1155/2019/5270159. PMID: 31781303Free PMC Article
Mittal SR, Pamecha S, Rohatgi R, Saxena R, Gokhroo R
Int J Cardiol 1992 Aug;36(2):187-96. doi: 10.1016/0167-5273(92)90006-o. PMID: 1512057

Clinical prediction guides

Wang W, Hao H, Fan T, Yue J, Wang M, Chen M, Deng G, Si L, Zhang F
Sci Rep 2023 May 3;13(1):7192. doi: 10.1038/s41598-023-34370-x. PMID: 37137970Free PMC Article
Tsai HJ, Tsai YC, Huang JC, Wu PY, Chen SC, Chiu YW, Chang JM, Chen HC
Dis Markers 2019;2019:5270159. Epub 2019 Nov 5 doi: 10.1155/2019/5270159. PMID: 31781303Free PMC Article
Messner E, Zohrer M, Pernkopf F
IEEE Trans Biomed Eng 2018 Sep;65(9):1964-1974. Epub 2018 Jun 1 doi: 10.1109/TBME.2018.2843258. PMID: 29993398
Jordan MD, Taylor CR, Nyhuis AW, Tavel ME
Arch Intern Med 1987 Apr;147(4):721-6. PMID: 3827460
Kino M, Shahamatpour A, Spodick DH
Am J Cardiol 1976 May;37(6):848-52. doi: 10.1016/0002-9149(76)90108-9. PMID: 1266747

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