Fourth: you mean fourth heart sound I presume. This is a sound produced just before the first heart sound that is related to abnormal relaxation of the heart. Read this: http://en.wikipedia.org/wiki/Fourth_heart_sound
Answered 12/1/2014
3.5k views
S4?: I think you are referring to what we call an S4 gallop. This is a 4th heart sound, not 4th heart beat. It is common in patients with hypertension or ventricles that are somewhat stiff from whatever cause.
Answered 4/24/2016
3.5k views
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