An S4 heart sound cannot be present during atrial ... jugular venous pulsations can be from V waves due to severe tricuspid regurgitation. A holosystolic murmur at the left lower sternal border ...

Diastolic murmurs include aortic and pulmonic regurgitation (early diastolic), and mitral or tricuspid stenosis ... Immediately before the S1 sound, active left ventricular filling occurs when ...