Cardiac Vascular Nursing Certification Practice Exam 2026 – Your All-in-One Guide to Exam Success!

The S4 heart sound, also known as a "late diastolic" sound, is typically associated with conditions where the heart is under increased workload or is experiencing stiffness in the left ventricle, such as hypertensive heart disease, aortic stenosis, or ischemic heart disease. It indicates that the left atrium is contracting against a stiff or hypertrophied ventricle, which may reflect an underlying pathology.

In contrast, the S3 heart sound, often referred to as a "physiological" sound, can be heard in healthy individuals, particularly in younger individuals or athletes, and may be benign. Heart murmurs can range widely in significance from benign to pathological, depending on characteristics like timing, location, and associated symptoms.

Understanding the context of these heart sounds is crucial for proper assessment and management. S4’s correlation with myocardial stiffness serves as a red flag in evaluating cardiac function, marking it as an adverse finding in clinical practice.