Presence of an S4 gallop is most closely associated with which condition?

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Multiple Choice

Presence of an S4 gallop is most closely associated with which condition?

An S4 gallop arises when the atria contract against a ventricle that is noncompliant or stiff, producing a late diastolic sound just before S1. This diastolic dysfunction is typical of a thickened, less elastic ventricle, such as in left ventricular hypertrophy from chronic hypertension or other causes of a stiff ventricle. Atrial fibrillation disrupts organized atrial contraction, so the atrial kick is absent and an S4 is unlikely. Dilated cardiomyopathy tends to show an S3 from rapid filling of a dilated, compliant ventricle rather than an S4, and valve stenosis can contribute to hypertrophy and stiffness but the classic association remains a stiff ventricle.

An S4 gallop arises when the atria contract against a ventricle that is noncompliant or stiff, producing a late diastolic sound just before S1. This diastolic dysfunction is typical of a thickened, less elastic ventricle, such as in left ventricular hypertrophy from chronic hypertension or other causes of a stiff ventricle. Atrial fibrillation disrupts organized atrial contraction, so the atrial kick is absent and an S4 is unlikely. Dilated cardiomyopathy tends to show an S3 from rapid filling of a dilated, compliant ventricle rather than an S4, and valve stenosis can contribute to hypertrophy and stiffness but the classic association remains a stiff ventricle.

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