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. .

heart sounds auscultation image

Popular Modules


Course and quiz certificates are available for users enrolled in Auscultation-Essentials or Advanced. Personalized achievement certificates can be printed and are 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.



Courses

Learn cardiac auscultation. 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.


Fundamentals of Heart Sounds   
An excellent starting point for learning heart sounds. This free course provides an overview of cardiac auscultation followed by 12 lessons.
Lesson List
1 Normal Heart Sounds
2 Splitting Second Heart Sound
3 Fixed Splitting Second Heart Sound
4 Third Heart Sound
5 Fourth Heart Sound
6 Innocent Murmur
7 Mid Systolic Click
8 Mitral Valve Leaflet Prolapse
9 Aortic Stenosis
10 Aortic Regurgitation
11 Mitral Regurgitation
12 Mitral Stenosis


Normal Heart Sounds  
This free course teaches 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.
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 sounds. 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




Third & Fourth Heart Sounds
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 systolic murmurs module includes seven lessons. We provide a textual description, audio recording, dynamic waveform video, and a cardiac animation in each lesson. Optionally, a quiz can be taken to measure comprehension and listening skills. Users who have selected our Auscultation-Basics, Essentials or Advanced plans can print achievement certificates and view their progress and scores using our personalized dashboard.
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




Complex Murmurs
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


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


Pediatric - Congenital
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


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


Auscultation Quizzes

We offer many graded quizzes, ranging from fundamentals to advanced topic. Quiz scores are saved to your personal dashboard.

Auscultation Quizzes
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