Heart Sounds Reference


This website provides several types of learning resources for heart auscultation. We offer courses, reference guides and repetition training. Each of these resources is described below. If you are a new visitor, we generally recommend starting with the Heart Sounds Lessons, moving from normal cardiac sounds (mini) course through murmurs and then congenital abnormalities.

Course completion certificates are now available. Signed-in users must review all course lessons and then pass a graded quiz. Personalized achievement certificates can be printed and are automatically saved to the user's dashboard.

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Cardiac Auscultation Reference Guide

Our auscultation reference guide includes over one hundred heart sounds, both real and simulated. Use these buttons to view sounds by auscultation area.


Listen to Heart Sounds: Repetition Training

In addition to our heart and lung sounds reference guide, we provide an auscultation repetition training web app. This app allows users to learn by continuously listening to heart sounds. Use this link: Auscultation Repetition Training.


Lessons

Learn cardiac auscultation by taking our lessons. These courses cover abnormal heart sounds including heart murmurs, third (S3) and fourth (S4) heart sounds and congenital conditions. Learn these sounds by selecting a topic from the table of contents below.


Normal Heart Sounds
This course will teach you about auscultation of normal sounds including split and unsplit second heart sounds heard at various heart rates and auscultation points.
Lesson List
1 First and Second Heart Sounds - Normal and Unsplit
2 First Heart Sound (Minimally Split)
3 Second Heart Sound - Physiologically Split #1
4 Third Heart Sound - Physiologic
5 Innocent Murmur
6 Exercise - Heart Rate 120


First Heart Sounds
This course will teach you about first heart sound auscultation. Before you take this course you should have finished the Normal Heart Sounds course and feel comfortable with your ability to listen and recognize normal heart sounds.
Lesson List
1 First Heart Sound - Loud
2 First Heart Sound (Minimally Split)
3 First Heart Sound (Markedly Split)
4 First Heart Sound - Decreased Intensity
5 Fourth Heart Sound Plus First Heart Sound
6 First Heart Sound plus Aortic Ejection Click




Second Heart Sounds
This course will teach you about the second heart sound. Before you take this course you should have finished the Normal Heart Sound and First Heart Sound courses. You should feel comfortable with the material presented.
Lesson List
1 Second Heart Sound - Physiologically Split #2
2 Second Heart Sound with Persistent Splitting
3 Second Heart Sound with Fixed Splitting
4 Second Heart Sound: Fixed Splitting, Increased Aortic Intensity
5 Second Heart Sound: Fixed Splitting, Decreased Aortic Intensity
6 Second Heart Sound and Late Systolic Click
7 Second Heart Sound and a Tumor Plop
8 Opening Snap and Second Heart Sound






Extra Heart Sounds (S3 and S4)
This course will teach you about auscultation of the third and fourth heart sounds. Before you take this course you should have finished the Normal, First, and Second Heart Sound courses. You should feel comfortable with the material presented.
Lesson List
1 Third Heart Sound Gallop
2 Fourth Heart Sound Gallop
3 Third and Fourth Heart Sound Gallop
4 Summation Gallop at 120 beats per minute




Systolic Murmurs
This course will teach you about Systolic Murmurs. Before you take this course you should have finished our auscultation courses titled Normal, First and Second Heart Sound, and Extra Heart Sound. You should feel comfortable with the material presented.
Lesson List
1 Innocent Murmur
2 Aortic Sclerosis (Musical Murmur)
3 Aortic Stenosis -Mild
4 Aortic Stenosis - Severe #2
5 Mitral Regurgitation
6 Mitral Valve Prolapse (Click with Late Systolic Murmur)
7 Hypertrophic Cardiomyopathy


Diastolic Murmurs
This course will teach you about auscultation of Diastolic Murmurs. Before you take this course you should have finished the Normal, First and Second Heart sound, and Extra Heart Sound courses. You should feel comfortable with the material presented.
Lesson List
1 Aortic Regurgitation - Mild
2 Pulmonic Regurgitation - Mild
3 Mitral Stenosis - Mild
4 Mitral Stenosis - Moderate
5 Mitral Stenosis - Severe
6 Tricuspid Stenosis - Moderate




Pediatric Referrals
This course will teach you when to refer pediatric patients. Before taking this course you should have completed our courses concerning heart sounds and murmurs and be comfortable with the material.
Lesson List
1 4 month old girl. Failure to thrive.
2 6 month old boy
3 4 year old with fainting episode
4 10 year old with chest pain.
5 6 month old with poor appetite
6 12 year old with respiratory infections
7 Twelve year old girl with periodic dizziness
8 Eleven year old girl seen after bicycle accident
9 Eight year old girl with elevated temperature
10 Eight year old boy with generalized malaise
11 Fifteen year old boy complains of dizziness


Complex Conditions
This course will teach you about complex conditions where there are murmurs in both systole and diastole. Before taking this auscultation course you should be familiar with the previous material on systolic murmurs, diastolic murmurs, extra heart sounds, etc.
Lesson List
1 Mitral Regurgitation - Severe
2 Tricuspid Regurgitation - Severe
3 Mitral Stenosis Severe and Regurgitation Mild - Rheumatic Origin
4 Aortic Stenosis Moderate and Regurgitation Mild - Rheumatic Origin
5 Mitral Regurgitation and Aortic Regurgitation
6 Acute Pericarditis


Congenital Abnormalities
This course will teach you how to identify the auscultatory sounds associated with congenital heart conditions. Before taking this course you should have completed the courses concerning heart sounds and murmurs and be comfortable with the material.
Lesson List
1 Coarctation of the Aorta
2 Patent Ductus Arteriosus
3 Atrial Septal Defect
4 Ventricular Septal Defect
5 Tetralogy of Fallot
6 Ebstein's Anomaly


Cardiac Conditions Associated with Sudden Death
This course will teach you how to identify sounds associated with conditions leading to sudden death. Before taking this course you should have completed the courses concerning heart sounds and murmurs and be comfortable with the material.
Lesson List
1 Hypertrophic Cardiomyopathy
2 Aortic Stenosis - Severe #2
3 Arrhythmogenic RV Dysplasia
4 Mitral Valve Prolapse (Click with Late Systolic Murmur)
5 Myocarditis
6 Commotio Cordis
7 Ebstein's Anomaly


Auscultation in Primary Care
This course is a survey of normal and abnormal sounds and murmurs encountered in primary care . The course starts with normal heart sounds and continues with extra heart sounds and murmurs.
Lesson List
1 First and Second Heart Sounds - Normal and Unsplit
2 First and Second Heart Sounds - Reduced Intensity
3 Second Heart Sound - Splitting
4 Third Heart Sound Gallop
5 Fourth Heart Sound Gallop
6 Third and Fourth Heart Sound Gallop
7 Summation Gallop at 120 beats per minute
8 Second Heart Sound - Fixed Splitting
9 Mid-Systolic Click
10 Mitral Valve Leaflet Prolapse
11 Aortic Stenosis (Diamond Shaped Systolic Murmur)
12 Aortic Regurgitation (Decrescendo Diastolic Murmur)
13 Mitral Regurgitation (pansystolic Murmur)
14 Mitral Stenosis (Diastolic Murmur)


Ultrasound Training

Certain heart sounds can also be diagnosed using sonography. Ultrasound is a great way to visualize valvular abnormalities. We recommend the website ultrasound.guide for free ultrasound training lessons and quizzes.


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