American Association of Critical-Care Nurses (AACN) Certification Practice Test

In which population is the S3 heart sound more frequently noted as normal?

1. Older adults with heart disease

2. Children and pregnant females

3. Patients with pulmonary hypertension

4. Individuals with chronic heart failure

The correct answer is: Children and pregnant females

The S3 heart sound, also known as a ventricular gallop, is often considered normal in specific populations due to physiological changes that occur in those groups. In children and pregnant females, the S3 sound is more common and typically indicates a healthy, functioning heart. In children, the heart's rapid growth and increased blood flow can create a more compliant ventricle, leading to the occurrence of an S3 sound during the early diastolic phase. This phenomenon is generally harmless and reflects the normal variation in the cardiac cycle during periods of growth and development. Pregnant females experience several cardiovascular changes, including increased blood volume and enhanced cardiac output, which can also result in an S3 sound. This is attributed to the increased compliance of the ventricle during pregnancy as the body accommodates the extra blood volume necessary to support the developing fetus. In contrast, the S3 heart sound is not typically considered a normal finding in older adults with heart disease, patients with pulmonary hypertension, or individuals with chronic heart failure, where the presence of an S3 sound may indicate underlying pathological conditions such as heart failure or diastolic dysfunction. Therefore, the presence of an S3 sound in children and pregnant females is a normal variant, while in other populations,