What is a Gallop Rhythm?

A gallop rhythm is a medical term for an additional heart sound that can usually be heard by stethoscope. It gets its name because it makes the heart sound similar to a horse running at a gallop. The significance of the rhythm is a little less clear-cut. It might indicate presence of a heart problem or could be completely benign, depending on other circumstances.

To confuse matters, there are two types of gallop rhythm called third and fourth sounds, which may be very close together so that they sound like one sound. These additional sounds are often called S₃ and S₄. As mentioned, presence of either of these sounds might be significant or might not be.

In particular, third heart sounds, S₃, could be completely normal. They are known to be common in children and young adults, and they may not cause concern unless there are symptoms of heart disease present. After the age of 40, an S₃ is often thought of as an important diagnostic tool suggesting there may some heart disease and that more inquiry is warranted.

There might be cause for concern if a third sound is present in children, since it can indicate certain forms of heart defects, and potentially small ventricular septal defects. Usually the third sound is watched and children might be referred to a cardiologist for greater testing if it continues or if other signs of a heart condition develop. If a child has displayed a gallop rhythm with a third sound for some time, it might make sense to see a cardiologist sooner, particularly if that child has any upcoming dental procedures. Even a small procedure like a cleaning could put the child at greater risk for endocarditis if he has any defect in the heart.

An S₄ gallop rhythm falls right before the first “beat- beat” of the heart, sounding as though it is interrupting the normal heartbeat process. Unlike third sound gallop rhythm, S₄ usually indicates serious problems with the heart. These could arise from certain congenital heart defects, or they could the result from damage to the heart or circulatory disease like high blood pressure. Enlarged or hypertrophic hearts can display this form of gallop rhythm too.

When a reliable fourth sound is heard, this usually warrants other testing to determine potential disease and to begin immediate treatment as is needed. Especially when this rhythm is caught early, disease can potentially be arrested before it is fully expressed. Attentive auscultation or listening with a stethoscope thus remains an important part of physical examination that should be respected. It may catch, long before other problems might be evident, a gallop rhythm that indicates heart disease, offering a potential for treatment much sooner.