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Third heart sound

MedGen UID:
68557
•Concept ID:
C0232237
•
Finding
Synonyms: S3; S3 - Third heart sound; Third heart sound, S>3<; Third heart sound, S>3<, function; Ventricular gallop
SNOMED CT: Third heart sound, S>3<, function (1285004); Third heart sound, S>3< (1285004); Third heart sound (277455002); S3 - Third heart sound (277455002)
 
HPO: HP:0031658

Definition

The third heart sound (S3) is related to rapid filling in diastole. S3 can be a normal finding in children and adolescents but suggests heart failure in older patients. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVThird heart sound

Professional guidelines

PubMed

Practices of clinical examination of heart failure patients in primary health care.
Laukkanen A, Ikäheimo M, Luukinen H
Cent Eur J Public Health 2006 Jun;14(2):86-9. doi: 10.21101/cejph.a3368. PMID: 16830611
Lack of efficacy of digoxin in treatment of compensated congestive heart failure with third heart sound and sinus rhythm in elderly patients receiving diuretic therapy.
Aronow WS, Starling L, Etienne F
Am J Cardiol 1986 Jul 1;58(1):168-9. doi: 10.1016/0002-9149(86)90264-x. PMID: 3728318

Recent clinical studies

Etiology

Burden of Heart Failure Signs and Symptoms, Prognosis, and Response to Therapy: The PARAGON-HF Trial.
Jering K, Claggett B, Redfield MM, Shah SJ, Anand IS, Martinez F, Sabarwal SV, Seferović PM, Kerr Saraiva JF, Katova T, Lefkowitz MP, Pfeffer MA, McMurray JJV, Solomon SD
JACC Heart Fail 2021 May;9(5):386-397. Epub 2021 Mar 10 doi: 10.1016/j.jchf.2021.01.011. PMID: 33714741
Investigation of Acoustic Cardiographic Parameters before and after Hemodialysis.
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
The third heart sound after exercise in athletes: an exploratory study.
Zhong LS, Guo XM, Xiao SZ, Wang D, Wu WZ
Chin J Physiol 2011 Aug 31;54(4):219-24. doi: 10.4077/CJP.2011.AMM049. PMID: 22129819
The third heart sound.
Joshi N
South Med J 1999 Aug;92(8):756-61. doi: 10.1097/00007611-199908000-00002. PMID: 10456711
Multifactorial index of cardiac risk in noncardiac surgical procedures.
Goldman L, Caldera DL, Nussbaum SR, Southwick FS, Krogstad D, Murray B, Burke DS, O'Malley TA, Goroll AH, Caplan CH, Nolan J, Carabello B, Slater EE
N Engl J Med 1977 Oct 20;297(16):845-50. doi: 10.1056/NEJM197710202971601. PMID: 904659

Diagnosis

A novel methodology for evaluation of S(2) wide split via estimated parameters.
Sun S, Song W, Tong Y, Li X, Zhao M, Deng Q, Liu G, Liu Z, Liu C
Comput Methods Programs Biomed 2023 Dec;242:107777. Epub 2023 Aug 30 doi: 10.1016/j.cmpb.2023.107777. PMID: 37714021
Diagnosis and evaluation of heart failure.
King M, Kingery J, Casey B
Am Fam Physician 2012 Jun 15;85(12):1161-8. PMID: 22962896
Hemodynamic correlates of the third heart sound and systolic time intervals.
Shah SJ, Michaels AD
Congest Heart Fail 2006 Jul-Aug;12 Suppl 1:8-13. doi: 10.1111/j.0889-7204.2006.05767.x. PMID: 16894268
Does this dyspneic patient in the emergency department have congestive heart failure?
Wang CS, FitzGerald JM, Schulzer M, Mak E, Ayas NT
JAMA 2005 Oct 19;294(15):1944-56. doi: 10.1001/jama.294.15.1944. PMID: 16234501
Third heart sound: genesis and clinical importance.
Mehta NJ, Khan IA
Int J Cardiol 2004 Nov;97(2):183-6. doi: 10.1016/j.ijcard.2003.05.031. PMID: 15458681

Therapy

Implantable defibrillator-detected heart failure status predicts ventricular tachyarrhythmias.
Compagnucci P, Casella M, Bianchi V, Franculli F, Vitali F, Santini L, Savarese G, Santobuono VE, Chianese R, Lavalle C, Amellone C, Pecora D, Calvanese R, Stronati G, Santoro A, Ziacchi M, Campari M, Valsecchi S, Calò L, Guerra F, Dello Russo A
J Cardiovasc Electrophysiol 2023 May;34(5):1257-1267. Epub 2023 Apr 10 doi: 10.1111/jce.15898. PMID: 36994907
Burden of Heart Failure Signs and Symptoms, Prognosis, and Response to Therapy: The PARAGON-HF Trial.
Jering K, Claggett B, Redfield MM, Shah SJ, Anand IS, Martinez F, Sabarwal SV, Seferović PM, Kerr Saraiva JF, Katova T, Lefkowitz MP, Pfeffer MA, McMurray JJV, Solomon SD
JACC Heart Fail 2021 May;9(5):386-397. Epub 2021 Mar 10 doi: 10.1016/j.jchf.2021.01.011. PMID: 33714741
Investigation of Acoustic Cardiographic Parameters before and after Hemodialysis.
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
Digoxin in heart failure and cardiac arrhythmias.
Campbell TJ, MacDonald PS
Med J Aust 2003 Jul 21;179(2):98-102. doi: 10.5694/j.1326-5377.2003.tb05445.x. PMID: 12864722
Multifactorial index of cardiac risk in noncardiac surgical procedures.
Goldman L, Caldera DL, Nussbaum SR, Southwick FS, Krogstad D, Murray B, Burke DS, O'Malley TA, Goroll AH, Caplan CH, Nolan J, Carabello B, Slater EE
N Engl J Med 1977 Oct 20;297(16):845-50. doi: 10.1056/NEJM197710202971601. PMID: 904659

Prognosis

Implantable defibrillator-detected heart failure status predicts ventricular tachyarrhythmias.
Compagnucci P, Casella M, Bianchi V, Franculli F, Vitali F, Santini L, Savarese G, Santobuono VE, Chianese R, Lavalle C, Amellone C, Pecora D, Calvanese R, Stronati G, Santoro A, Ziacchi M, Campari M, Valsecchi S, Calò L, Guerra F, Dello Russo A
J Cardiovasc Electrophysiol 2023 May;34(5):1257-1267. Epub 2023 Apr 10 doi: 10.1111/jce.15898. PMID: 36994907
Burden of Heart Failure Signs and Symptoms, Prognosis, and Response to Therapy: The PARAGON-HF Trial.
Jering K, Claggett B, Redfield MM, Shah SJ, Anand IS, Martinez F, Sabarwal SV, Seferović PM, Kerr Saraiva JF, Katova T, Lefkowitz MP, Pfeffer MA, McMurray JJV, Solomon SD
JACC Heart Fail 2021 May;9(5):386-397. Epub 2021 Mar 10 doi: 10.1016/j.jchf.2021.01.011. PMID: 33714741
Investigation of Acoustic Cardiographic Parameters before and after Hemodialysis.
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
Signs and symptoms in adult patients with acute dyspnea: a systematic review and meta-analysis.
Renier W, Winckelmann KH, Verbakel JY, Aertgeerts B, Buntinx F
Eur J Emerg Med 2018 Feb;25(1):3-11. doi: 10.1097/MEJ.0000000000000429. PMID: 29252938
The third heart sound.
Joshi N
South Med J 1999 Aug;92(8):756-61. doi: 10.1097/00007611-199908000-00002. PMID: 10456711

Clinical prediction guides

Implantable defibrillator-detected heart failure status predicts ventricular tachyarrhythmias.
Compagnucci P, Casella M, Bianchi V, Franculli F, Vitali F, Santini L, Savarese G, Santobuono VE, Chianese R, Lavalle C, Amellone C, Pecora D, Calvanese R, Stronati G, Santoro A, Ziacchi M, Campari M, Valsecchi S, Calò L, Guerra F, Dello Russo A
J Cardiovasc Electrophysiol 2023 May;34(5):1257-1267. Epub 2023 Apr 10 doi: 10.1111/jce.15898. PMID: 36994907
Subclinical Myocardial Injury and the Phenotype of Clinical Congestion in Patients With Heart Failure and Reduced Left Ventricular Ejection Fraction.
Thibodeau JT, Pham DD, Kelly SA, Ayers CR, Garg S, Grodin JL, Drazner MH
J Card Fail 2022 Mar;28(3):422-430. Epub 2021 Sep 14 doi: 10.1016/j.cardfail.2021.09.002. PMID: 34534666
Burden of Heart Failure Signs and Symptoms, Prognosis, and Response to Therapy: The PARAGON-HF Trial.
Jering K, Claggett B, Redfield MM, Shah SJ, Anand IS, Martinez F, Sabarwal SV, Seferović PM, Kerr Saraiva JF, Katova T, Lefkowitz MP, Pfeffer MA, McMurray JJV, Solomon SD
JACC Heart Fail 2021 May;9(5):386-397. Epub 2021 Mar 10 doi: 10.1016/j.jchf.2021.01.011. PMID: 33714741
Investigation of Acoustic Cardiographic Parameters before and after Hemodialysis.
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
The third heart sound.
Joshi N
South Med J 1999 Aug;92(8):756-61. doi: 10.1097/00007611-199908000-00002. PMID: 10456711

Recent systematic reviews

Signs and symptoms in adult patients with acute dyspnea: a systematic review and meta-analysis.
Renier W, Winckelmann KH, Verbakel JY, Aertgeerts B, Buntinx F
Eur J Emerg Med 2018 Feb;25(1):3-11. doi: 10.1097/MEJ.0000000000000429. PMID: 29252938

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