What is the most common heart sound finding in patients with normal sinus rhythm indicating decreased left ventricular compliance?

In patients with normal sinus rhythm, the most common heart sound associated with decreased left ventricular compliance is the fourth heart sound, often referred to as S4. This sound is generated during the late diastolic phase when the atria contract and push blood into a stiff or hypertrophied ventricle that cannot easily accommodate the incoming volume. The presence of S4 often indicates that the left ventricle is not compliant, which can be a sign of conditions such as left ventricular hypertrophy or heart failure.

The other heart sounds mentioned have different implications. S1 and S2 are normally associated with the closure of the atrioventricular and semilunar valves, respectively, and do not specifically indicate compliance issues. S3, while also an extra heart sound, is typically associated with volume overload situations and indicates rapid filling of the ventricle, which is different from the stiffness indicated by S4. Thus, recognizing S4 in this context is crucial for understanding issues related to left ventricular compliance in patients with heart conditions.