Which statement correctly describes the S3 heart sound?

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S3 is a ventricular gallop heard in early diastole just after S2, produced by rapid filling of a ventricle that is volume overloaded or dilated. It is classically linked to increased preload and fluid status, such as in heart failure or other states with high filling pressures. That’s why describing it as a Kentucky gallop with increased fluid status fits best. In contrast, an S4 (often remembered by the Tennessee gallop) reflects a stiff, noncompliant ventricle and is heard with atrial contraction late in diastole, not early diastole. Descriptions linking S3 to valvular disease aren’t typical, and decreased preload would actually suppress S3 rather than create it.