Cardiac auscultation, or listening to a patient’s heart sounds, represents an integral part of the clinician’s physical exam and diagnostic approach.

For example, picking up acute mitral valve regurgitation or listening to a crashing inpatient with new-onset shortness of breath and pulmonary edema, or suspecting pericarditis on auscultation of a clinic patient with pleuritic chest pain, can contribute greatly to patient management.

Nonetheless, heart auscultation can be challenging to learn and difficult to master, even for the brightest and most diligent medical students and residents.

Read below the jump to learn more about how Heart Murmur Pro can help you master cardiac auscultation.

Heart sounds can be soft, and their differences subtle. While many strong resources directed at teaching cardiac auscultation exist, today we review the Heart Murmur Pro app from Hipposoft for the iPhone/iPad.

Hipposoft Medical Software Solutions has developed several other medically-oriented applications, including Atlas of Anatomy, Physical Exam Essentials, Anatomy Pronunciations, Drug Pronunciations, Microbiology Pronunciations, and Hospital Codebook/Phonebook.

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The Heart Murmur Pro app opens with “Recommended Apps,” which consists of several of Hipposoft’s other aforementioned medically-oriented apps.

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The app itself features a home screen with quick access to the 23 heart sounds contained in the app, beginning with normal heart sounds. The index bar at the bottom of the screen features links for this sound library, favorites, quiz mode, quiz history, and further info.

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The info tool is notable for its inclusion of a “Cardiac Exam Guide.” Moreover, note that headphones are recommended for best results when using this app.

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This Cardiac Exam Guide represents a solid introduction to cardiac auscultation, depicting the different regions of the chest for listening, as well as discussing how to properly describe heart murmurs.

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For our example here, we explore the Aortic Stenosis heart murmur from the sound library. The screen depicts where on the chest to best appreciate the murmur of interest (here, right upper sternal border), and plays a looping audio clip of the murmur, complete with a tracker that traverses through a marked S1 and S2 along the bottom. The audio clip can only be stopped and re-started; users cannot speed up or slow down the audio speed.

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Clicking on the “Info” button in the top right links to a synopsis of the chosen murmur. This synopsis includes information on location, description, etiology, pathophysiology, clinical presentation, physical examination, diagnostic evaluation, and treatment associated with the particular murmur.

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Moreover, each murmur synopsis ends with links for more information via Google, Wikipedia, and Medline Plus. Clicking these links allows for in-app navigation to additional information about the murmur on these resources, a nice feature of the app.

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The app also offers the ability for users to designate murmurs as “Favorites” for quick recall and dedicated quizzing.

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The Quiz Mode feature, a highlight of the Heart Murmur Pro app, allows for the generation of quizzes on common murmurs, systolic murmurs, diastolic murmurs, favorites, all murmurs, and custom selection of murmurs.

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Generating a quiz allows for two options along the bottom—a multiple-choice quiz and a free-answer quiz.

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The multiple-choice option displays the location and audio file of the murmur, and then offers three possible murmurs and “none of the above” as options.

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Users receive instant feedback on the correctness of their answer. Moreover, users can also select one of the incorrect answer choices to quickly listen to the other murmurs and view the relevant synopses for reference.

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The free-answer quiz option displays the murmur’s location and plays its audio, allowing for users to reveal the answer, without choices as above.

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Clicking to reveal the answer displays the name of the murmur and places the murmur tracing on the audio cursor.

Pricing:

  • Heart Murmur Pro costs $2.99 at the iTunes store.

Likes:

  • Cardiac exam guide provides a nice introduction to heart auscultation
  • In-depth overview of 23 heart sounds
  • In-app links to Medline Plus, Wikipedia, and Google for additional information
  • Quiz mode is a nice feature to test your mastery of heart sounds

Dislikes:

  • App lacks the ability to speed up or slow down audio clips
  • The app always opens with the “Recommended Apps” screen, which quickly becomes rather irritating

Conclusion:

  • The reasonably-priced Heart Murmur Pro App from Hipposoft represents a clean yet feature-laden tool to facilitate mastery of the difficult skill of cardiac auscultation