Heart Auscultation Case Summary
Summary: John Doe, a fifty-year-old male presents to the Emergency Room with chest pain that has lasted for about 6 hours and is slightly relieved by nitroglycerin; the patient is also experiencing dyspnea as well as nausea. A fourth heart sound was discovered upon cardiac examination, and an angiogram revealed right coronary artery occlusion.
Question: What is it that physiologically occurs during a myocardial infarction which leads to the formation of an S4 sound?
Generate:
Heart auscultation is useful in characterizing heart sounds and identifying abnormalities that may suggest cardiac dysfunction.1 The fourth heart sound (S4 atrial gallop), heard during the patient’s physical examination, is often an abnormal finding due to reduction in ventricular wall compliance.1,2 Additionally, S4 occurs due to rapid deceleration of active blood flow due to a nondistensible ventricle.2 S4 can be heard in patients with hypertension, hypertrophic cardiomyopathy and acute myocardial infarction (AMI).1,2
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As lipid-rich plaque builds up overtime, the vascular wall accommodates a large portion of it through outward remodeling. The purpose of the outward remodeling is to preserve blood flow, however once the compensatory mechanism is exhausted, the plaque becomes unstable and enters the lumen of the vasculature, thus impeding blood
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