Module 4: Discussion
Mrs. K is a 60-year-old white female who presented to the ER
with complaints of her heart “beating out of my chest.” She is complaining that
she is having increased episodes of shortness of breath over the last month and
in fact has to sleep on 4 pillows. She also notes that the typical swelling
she’s had in her ankles for years has started to get worse over the past two
months, making it especially difficult to get her shoes on toward the end of
the day. In the past week, she’s been experiencing fatigue and decreased urine
output. Her past history is positive for an acute anterior wall myocardial
infarction and coronary artery bypass surgery. She was a 2 pack a day smoker,
but quit 8 years ago.
On physical examination, auscultation of the heart revealed
a rumbling S3 gallop and inspiratory crackles. She has +3 edema of the lower
extremities.
1. Discuss the pathophysiology of an S3 heart sound and
include causes for an S3 gallop?
