CLINICAL DIAGNOSTIC MANUAL
Added heart sounds are additional noises beyond the normal first (S1) and second (S2) heart sounds. These sounds may indicate structural or functional abnormalities of the heart. The most common added sounds include the third (S3) and fourth (S4) heart sounds, clicks, and snaps. Identifying and evaluating these sounds can provide valuable information about various cardiac pathologies and their severity.
Pathology | Suspected Diagnosis | Confirmatory Diagnosis |
Physiological | Mild and transient added sounds, no other symptoms. | Clinical history, physical examination, echocardiogram. |
Heart failure | Dyspnoea, orthopnoea, peripheral oedema, presence of S3 or S4. | Echocardiogram, chest X-ray, blood tests (BNP). |
Cardiomyopathy | Dyspnoea, fatigue, palpitations, presence of S3 or S4. | Echocardiogram, cardiac MRI (CMR), blood tests (troponins). |
Constrictive pericarditis | Chest pain, dyspnoea, hepatomegaly, pericardial knock. | Echocardiogram, CMR, cardiac catheterisation. |
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