This is a young woman with non-ischemic cardiomyopathy related to methamphetamine use, who was admitted to the hospital for decompensated heart failure. She was found to have a right-sided S3 gallop that was visualized via precordial movement. The swab transmits three distinct impulses – the last impulse is the S3 gallop.
This patient also has a holosystolic murmur over the left lower sternal border that increases in intensity with inspiration (Carvallo’s sign).
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