I had received an abnormal EKG several months ago. It might have been due to my neck bones flattening my spine and affecting my heart.

I just had a new cardiologist take a new EKG and exam. This most recent report from the doctor stated the following : HEART: PMI at the 5th ICS MCL. S1/S2 regular. S4 present. What does this mean? Is it good or bad.

Thank you.