<prompt> S4 is not seen in :Ventricular aneurysmMitral regurgitationHyperophic cardiomyopathyHypeension  <response>: Answer is A Ventricular aneurysm In ventricular aneurysm the ventricle becomes more compliant than normal and offers lesser resistance to .filling and hence no S4 is heard. S4 is characteristically absent in ventricular aneurysm due to increased ventricular compliance. Fouh hea sound Sa Is low pitched, presystolic sound, produced in ventricle during 2d rapid filling phase. It is associated with effective atrial contraction. It occurs when there is increased resistance to ventricular filling due to diminished ventricular compliance 