A<unk>  refers to a (usually abnormal)<unk>  of the heart on auscultation. It includes three or four sounds, thus resembling the sounds of a<unk> .
The normal heart<unk>  contains two audible heart sounds called the first heart sound or  (S1) and the second heart sound (S2) that give the well-known "lub-dub"<unk> .  These two heart sounds are caused by the closing of valves in the heart.
A<unk>  contains another sound, called S3 or S4, dependent upon where in the cycle this added sound comes.
It can also contain both of these sounds forming a quadruple<unk> , and in situations of very fast heart rate can produce a summation<unk>  where S3 and S4 occur so close as to be indistinguishable.
Gallop rhythm
Bigeminal rhythm
Breathe odor
Bloating
Flame
Overeating
Irregular pulse
Trench mouth