what is the cause of s3 heart sound
Third heart sound S3 is thought to be caused by the oscillation of blood back and forth between the walls of the ventricles initiated by the inflow of blood from the atria. The reason the third heart sound does not occur until the middle third of diastole is probably that, during the early part of diastole, the ventricles are not filled sufficiently to create enough tension for reverberation. It may also be a result of tensing of the chordae tendineae during rapid filling and expansion of the ventricle.
Cardiac cycle "Ventricular diastole," begins when the ventricles starts to relax. At this point, some blood of the previous cycle's systole is still flowing out of the ventricles through the semilunar valves, due to the inertia of the moving blood column, which overcomes the higher pressure in the aorta/pulmonary trunk with respect to the pressure in the ventricles. This short lasting phase, called "protodiastole" ends with the closure of the semilunar valves, producing the second heart sound (S2). Now that both the AV valves and the semilunar valves are closed, the ventricles are now closed chambers. Hence, this phase is known as isovolumetric (also called isovolumic, isometric) relaxation phase. Then the atrioventricular (AV) valves (the mitral valve and the tricuspid valve) open, allowing blood to fill the ventricles. This ventricular inflow phase can be sub-divided into the 'first rapid filling phase' as blood rushes in from the atria as a result of ventricular dilation; a phase of slow ventricular filling called 'Diastasis', and the 'last rapid filling phase' due to atrial contraction (systole).