Third heart sound in health and disease

Third heart sound in health and disease Third heart sound (S3) occurs in early diastole due to rapid deceleration of transmitral blood flow as the ventricles fill [1]. It corresponds in timing to shortly after the peak of the early diastolic E wave of transmitral flow. S3 occurs just after the opening of the atrioventricular valve as blood filling the atria during ventricular systole flows quickly into the ventricles [2]. Third heart sound can occur under physiological conditions as well as in disease, though not heard in all individuals. A prospective study of 580 patients had isolated valvular mitral regurgitation in 299, aortic regurgitation in 121 and primary left ventricular dysfunction with or without functional mitral regurgitation in 160 [3]. Association between audible S3 noted in routine clinical practice by internal medicine physicians and hemodynamic alterations measured by Doppler echocardiography was checked. S3 was more often heard in patients with primary left ventricular dysfunction (46%), compared to mitral (16%) or aortic regurgitation (12%). Patients with S3 were more likely to have class III-IV symptoms and higher mean pulmonary arterial pressures. It was a marker of severe regurgitation in all patient groups, with highest odds ratio in mitral regurgitation. While S3 was associated with marked dilatation in mitral regurgitation, it was associated with ejection fraction <50% in aortic regurgitation. Physiological S3 is because of rapid early diastolic ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology Source Type: blogs