During a physical examination, which heart sound is indicative of potential left ventricular hypertrophy?

The presence of an S4 heart sound, also known as the "atrial gallop," can indicate potential left ventricular hypertrophy (LVH). This sound occurs just before the S1 heart sound and is produced by the atria contracting against a stiff or hypertrophied left ventricle. In individuals with LVH, the ventricular wall becomes thickened and less compliant, making it more difficult for blood to fill during atrial contraction. This increased resistance can lead to the early closure of the mitral valve, which is reflected in the S4 sound.

S4 is particularly associated with conditions such as hypertension and aortic stenosis, both of which can contribute to the development of left ventricular hypertrophy. Therefore, detecting an S4 during a physical examination can provide valuable diagnostic information regarding the patient's cardiac function and potential structural changes in the heart.