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S3 and S4 are low-frequency diastolic sounds that originate in the ventricles. The S3 sound is indicative of elevated volume of blood inside the ventricle. An S3 is capable to be distinguished as either left- or correct-sided by whether or not or not it increases in intensity with inhalation or exhalation. A correct-sided S3 will enhance upon inhalation, and a left-sided S3 will raise with exhalation. There are two standard heart sounds, labeled S1 and S2, and additional heart sounds labeled S3 and S4. The clichéd “Lub-Dub” of the heartbeat heard by means of a stethoscope minimizes and understates the complexity of what in fact is occurring.
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