S3 - Indication

• A. Most commonly heard in the early stages of Left-sided heart failure
• B. Associated with pulmonary hypertension
• C. Commonly heard in right heart failure
• D. Normal in healthy adults

Answer: (A)

An S3 gallop comes from rapid, early diastolic filling of a dilated ventricle when there is volume overload. This is most characteristic of left-sided heart failure, where elevated pressures in the left ventricle cause a swift rush of blood during early diastole, producing that extra sound after S2. Because of that left-sided volume overload pattern, S3 is not a normal finding in healthy adults (except in young people) and is not the primary sign of right-sided disease. While pulmonary hypertension can coexist with heart problems, it isn’t the classic trigger for an S3. Therefore, the best choice is that S3 is most commonly heard in the early stages of left-sided heart failure.