<Table> <Tr> <Th_colspan="2"> Fourth heart sound </Th> </Tr> <Tr> <Th_colspan="2"> Classification and external resources </Th> </Tr> <Tr> <Th> ICD - 9 - CM </Th> <Td> 427.9, 785.3 </Td> </Tr> <Tr> <Th> DiseasesDB </Th> <Td> 4938 </Td> </Tr> <Tr> <Td_colspan="2"> (edit on Wikidata) </Td> </Tr> </Table> <Tr> <Th_colspan="2"> Fourth heart sound </Th> </Tr> <Tr> <Th_colspan="2"> Classification and external resources </Th> </Tr> <Tr> <Th> ICD - 9 - CM </Th> <Td> 427.9, 785.3 </Td> </Tr>

In older adults the presence of heart sound s4 suggests