This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: C.V.S, Subject name: Medicine
S4 is not seen in- 
Select and explain. 
A. Ventricular aneurysm, B. Mitral regurgitation, C. Hyperophic cardiomyopathy, D. Hypeension
A: Ventricular aneurysm
Answer: A: Ventricular aneurysm 
Explanation: A fouh hea sound is commonlyheard due to decreased ventricular compliance. It can sometimes heard immideatly before the first sound when atrial pressure is high or the ventricle is stiff in conditions like ventricular hyperophy. Ref Harrison 20th edition pg 1557