Clinical features

Why?

A third heart sound makes a myocardial infarction more likely

Patient	Target Disorder and Reference Standard	Diagnostic Test	LR+ (95% CI)	Post-test Probability	LR- (95% CI)	Post-test Probability
anterior chest pain b (pre-test probability: 12%)	myocardial infarction (cardiac enzymes, ECG)	third heart sound on auscultation	3.2 (1.6 to 6.5)	31%	0.88 (0.79 to 0.99)	11%

A clearly audible S4 increases the risk of dying.

Patient	Prognostic Factor	Outcome	CER	OR (95% CI)	NNF+ (95% CI)
myocardial infarction c	clearly audible S4 not independent	death at 5 years	12%	4.29 (1.10 to 16.75)	4 (4 to 96)