Clinical Aspects of Gallop Rhythm with Particular Reference to Diastolic Gallops

Abstract

Gallops are classified as systolic or diastolic. The systolic gallop (or click) is often a benign finding. Diastolic gallops are further subdivided into atrial and ventricular gallops. The atrial gallop is related to atrial contraction and may occur in the absence of congestive heart failure. It is frequently heard when there is a delay in atrioventricular conduction (prolonged P-R interval) and occasionally when the P-R interval is normal. It is also common with hypertension. The ventricular (or 3d heart sound type) is almost always associated with heart failure and often represents the first clue to serious heart disease and congestive failure. The ventricular gallop usually carried a more grave prognosis as compared with the atrial gallop. Methods of differentiation of these gallops are discussed as a practical clinical application.