Heart Songs 4
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Are You Getting The Most Out Of Your Stethoscope?

In a voluntary study of 1,100 cardiologists, participants were able to recognize fewer than half of basic murmurs and only two-thirds of advanced murmurs. How confident are you in your cardiac auscultation skills?

Heart Songs 4 provides you with everything you need to effortlessly improve your cardiac auscultation skills! Simply watch/listen to each high definition video within Heart Songs 2 to 4 times to master each murmur. The videos include descriptions of each murmur, images of phonocardiograms, CT scans and color Doppler echos, intermixed with 200 repetitions of each murmur. Interactive quizzes let you measure your baseline skill and your level of improvement. And best of all, once you've mastered a sound, it will be reinforced every time you hear it in a patient.

After only 90 minutes using Heart Songs, the study participants nearly doubled their score on the basic murmurs and saw a 30% score improvement for advanced murmurs. The stethoscope is as important today as it was 200 years ago. Do you know what yours is telling you?

With Heart Songs 4, you will.

  Heart Songs 4 Table of Contents
  Heart Songs 4 Table of Contents

Basic Murmurs

Intermediate Murmurs

Basic Pre Test


  • Aortic Stenosis
  • Mitral Regurgitation
  • Innocent Murmur
  • Aortic Regurgitation
  • Mitral Stenosis
  • Fourth Heart Sound
  • Third Heart Sound
  • Summation Gallop
  • Pericardial Rub
  • Review Session 1

Basic Post Test

Intermediate Pre Test


  • Bicuspid Aortic Valve
  • Mitral Valve Prolapse
  • Hypertrophic Cardiomyopathy
  • Aortic Sclerosis
  • Tricuspid Regurgitation
  • Review Session 2

Intermediate Post Test

Advanced Murmurs

Adult Congenital Murmurs

Advanced Pre Test


  • Advanced Aortic Stenosis
  • Advanced Aortic Regurgitation
  • Advanced Mitral Regurgitation
  • Advanced Mitral Stenosis
  • Review Session 3

Advanced Post Test

Adult Congenital Pre Test


  • Atrial Septal Defect
  • Ventricular Septal Defect
  • Patent Ductus Arteriosus
  • Tetralogy of Fallot
  • Ebstein's Anomaly
  • Review Session 4

Adult Congenital Post Test

  Editors & Release Dates:
  Editors & Release Dates:

Editors: Michael J. Barrett, MD, FACC

Nurse Planner: Chris Keenan, RN, MSN, CCRN

Date of Release: 3/31/2016

Date of Expiration: 3/31/2019

  Target Audience & Learning Objectives
  Target Audience & Learning Objectives

Target Audience

The target audience includes any healthcare professional interested in improving his/her cardiac auscultation skills.

Learning Objectives

Upon completion of Heart Songs 4, learners will be able to demonstrate improved recognition and differentiation of:

  • Basic heart sounds including third, fourth sounds, summation gallops and pericardial rubs.
  • Essential diagnostic heart sounds/murmurs including hypertrophic cardiomyopathy and mitral valve prolapse.
  • Advanced heart murmurs including aortic/mitral stenosis and regurgitation.
  • Heart sounds associated with congenital disorders including atrial and ventricular septal defects.
  Format and Pricing
  Format and Pricing

This program is available online featuring the following:

  • Heart Songs in MPEG-4 files (HD video)
  • Interactive quizzes (online)

Members: $150
Nonmembers: $190
FITs/CCAs/Emeritus: $75

  CME, CE, and MOC Information
  CME, CE, and MOC Information
  Accreditation for Physicians
  Accreditation for Physicians
The American College of Cardiology Foundation (ACCF) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The ACCF designates this enduring material for a maximum of 10 AMA PRA Category 1 Credit(s). Physicians should claim only the credit commensurate with the extent of their participation in the activities.

While offering CME credits noted above, this program is not intended to provide extensive training or certification in the field.
  Accreditation for Nurses
  Accreditation for Nurses
The American College of Cardiology Foundation is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

The ACCF designates this educational activity for a maximum of 10 continuing education hours.

Requirements for successful completion include completing the pretest, watching all videos at least twice, and achieving a score of 70% or better on the posttests.

While offering the CME/CNE credits noted above, this program is not intended to provide extensive training or certification in the field.
  Maintenance of Certification (MOC)
  Maintenance of Certification (MOC)
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 10 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
  Research Basis for Heart Songs
  Research Basis for Heart Songs

"Research demonstrates that practice makes perfect when trying to master cardiac auscultation. Listening to these "Heart Songs" at the computer or iPod can help clinicians at every level refine their auscultation skills." Michael J. Barrett, MD, FACC

Cardiac auscultation has traditionally been taught as if it were an intellectual skill, with a didactic lecture followed by a brief demonstration of heart sounds. This approach has yielded disappointing results, with most clinicians able to recognize only about 40% of abnormal heart sounds. Heart Songs, on the other hand, is based on psychoacoustic research demonstrating that intensive repetition (400 to 600 times) is required for the human brain to master a new sound. This degree of repetition is necessary for the formation of an auditory template of each new sound. Once each new sound is mastered, it is reinforced each time you hear it in a patient. By using this learning principle from psychoacoustic research, Heart Songs produces a significant improvement in cardiac auscultation in a relatively short time. Two controlled trials1,2 have shown that proficiency in cardiac auscultation routinely exceeds 80% using this approach.

Heart Songs 4 provides you with high-quality heart sounds that you can listen to at your convenience so you can improve your cardiac auscultation skills.



  1. Barrett MJ, Lacey CS, Sekara AE, Linden EA, Gracely EJ. Mastering cardiac murmurs: the power of repetition. Chest 2004;126:470-5.
  2. Barrett MJ, Kuzma MA, Seto TC, et al. The power of repetition in mastering cardiac auscultation. Amer J Med 2006;119:73-5.
  3. Barrett MJ, Martinez MW, Scott M, O'Gara PT. How accurate are cardiologists at detecting aortic and mitral murmurs? A reality check on auscultation skills in the era of transcatheter interventions. Eur Heart J 2015;36;792.
  4. Chizner MA. Cardiac auscultation: rediscovering the lost art. Curr Probl Cardiol. 2008;33:326-408.