Given that it only happens in 4th gear I would suspect a transmission issue instead of an engine performance issue. If it’s a manual transmission it’s likely to be a clutch problem meaning the clutch is worn out but if it’s an automatic perhaps the 4th gear clutches are having a problem. It’s EXTREMELY important that you only use Honda fluid in a Honda automatic so if you have other fluid in there you might consider changing it to OE however if you already have a problem with worn internals changing the fluid will probably do little to help the problem.
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- 90 Accord bogs down in 4th gear.