Final answer:
The S4 sound indicates hypertrophic cardiomyopathy, a possible result of long-standing hypertension, confirming the presence of target organ damage which is a serious risk factor for heart disease.
Step-by-step explanation:
An S4 heart sound heard over the heart indicates hypertrophic cardiomyopathy, which is a form of target organ damage resulting from hypertension (HTN). Auscultation using a stethoscope allows for the detection of this fourth heart sound, which occurs prior to the first heart sound (S1). The S4 sound is produced when the atria contract and push blood into a stiff or hypertrophic, meaning abnormally enlarged, left ventricle that is failing to function properly. This can be a direct consequence of the added strain on the heart caused by persistent HTN. An echocardiogram may be ordered to further investigate the presence of hypertrophic cardiomyopathy or any valve disorders indicated by abnormal heart sounds like S4, also known as an atrial gallop or the “Tennessee gallop.”