Heart Sounds and Murmurs.
The PracticalClinicalSkills.com website provides multiple ways to learn heart sounds and murmurs. We offer courses, course-quizzes, reference guides and repetition drills. Each of these resources is described below. We suggest starting with the heart sounds mini-courses along with the related quizzes. It is best to begin with normal sounds, then first, second and third/fourth heart sounds, then adding the several abnormal murmurs. .
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.
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.
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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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) |
Popular Links
First Heart Sounds
Second Heart Sounds
Third and Fourth Heart Sounds
Systolic Murmur
Aortic Sclerosis
Aortic Stenosis
Acute Pericarditis
Aortic Regurgitation
Atrial Septal Defect
Cardiomyopathy
Coarctation of the Aorta
Innocent Murmur
Mitral Regurgitation
Mitral Stenosis
Mitral Valve Prolapse
Myocarditis
Pulmonic Regurgitation
Tetralogy of Fallot
Tricuspid Regurgitation Severe
Tricuspid Stenosis
Ventricular Septal Defect
Pediatric Referral Cases
Second Heart Sounds
Third and Fourth Heart Sounds
Systolic Murmur
Aortic Sclerosis
Aortic Stenosis
Acute Pericarditis
Aortic Regurgitation
Atrial Septal Defect
Cardiomyopathy
Coarctation of the Aorta
Innocent Murmur
Mitral Regurgitation
Mitral Stenosis
Mitral Valve Prolapse
Myocarditis
Pulmonic Regurgitation
Tetralogy of Fallot
Tricuspid Regurgitation Severe
Tricuspid Stenosis
Ventricular Septal Defect
Pediatric Referral Cases
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.
This website is only for medical professional education. Contact a healthcare provider for medical care. 2021 © Clinical Skills Education LLC. All Rights Reserved.
