What heart sound is often associated with heart failure or volume overload?

The third heart sound, known as S3, is often associated with heart failure or volume overload. This sound occurs during the rapid filling phase of the ventricles in early diastole and is indicative of increased atrial pressure. In the context of heart failure, it often results from the inability of the ventricle to efficiently handle the increased volume returning to it, leading to a phenomenon known as "volume overload."

In healthy individuals, S3 may not be present, or if it is, it is often benign (physiologic) in nature. However, in patients with heart failure, the presence of S3 is typically a sign that the ventricle is stiff and less compliant, which is a direct consequence of the deteriorating pump function. This sound can serve as an important clinical indicator for healthcare providers when assessing a patient's cardiovascular status, especially in critically ill patients.

The other heart sounds do not have the same direct association with heart failure. For instance, S1 and S2 correspond to the closing of the atrioventricular and semilunar valves respectively and are more related to the normal cardiac cycle rather than changes in volume status. S4, on the other hand, typically indicates a stiff left ventricle