What cardiac physiology does the S4 heart sound represent?
a. Closure of the mitral and tricuspid valves
b. Ventricular contraction
c. Closure of the aortic valve and pulmonic valves
d. Increased ventricular filling pressures, such as in heart failure
e. Atrial contraction against a stiff ventricle, as seen in left ventricular hypertrophy



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