In left ventricle heart failure, which auscultatory finding is described?

• A. Shortness of breath with edema
• B. JVD
• C. Edema
• D. S3

Answer: (D)

A loud third heart sound (S3) is the auscultatory finding associated with left ventricular failure. In this scenario, the failing ventricle is dilated and receives a large volume of blood during early diastole. The rapid, passive filling of this volume into a ventricle with higher filling pressures creates an extra, low-pitched sound after the second heart sound—the ventricular gallop known as S3. It reflects elevated left-sided filling pressures and systolic dysfunction, and is most easily heard with the patient in the left lateral position using the bell at the apex during early diastole.

The other options describe symptoms or signs (shortness of breath with edema) or signs of congestion (JVD, edema) rather than an auscultated sound, and one would contrast S3 with S4, which is a late diastolic sound due to a stiff ventricle rather than volume overload.