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These sounds are of much lower frequency than the valve sounds and may be difficult to hear.
They are best heard with the bell gently applied to the chest and are described as a dull thud becoming palpable when loud.
Ventricular filling sounds include:
The third sound is normally audible in children, with the intensity diminishing with age. The third heart sound becomes inaudible (but recordable) in normal subjects in middle age with increasing ventricular stiffness.