ممرض يقيّم مريضاً ويسمع صوتاً ثالثاً (S3) عند القمة. في أي حالة يكون هذا الصوت مقلقاً أكثر؟

A nurse hears an S3 at the apex. In which client is this sound most concerning?

1. An 8-year-old after running
2. A 64-year-old man with breathlessness and ankle swelling
3. A woman in the third trimester without symptoms
4. An asymptomatic 20-year-old athlete

Answer: B) A 64-year-old man with breathlessness and ankle swelling. An S3 can be normal in children, young athletes and pregnancy because of rapid filling. In an older adult with congestive symptoms it usually means heart failure and volume overload.