A murmur is due to turbulence of blood flow and ... The S3 can be normal, at times, but may be pathologic. A S4 heart sound is almost always pathologic. Heart sounds can be described by their ...

An S4 heart sound cannot be present during atrial ... from V waves due to severe tricuspid regurgitation. A holosystolic murmur at the left lower sternal border louder with inspiration is due ...