Telemedica is working on auscultation education to build a better relationship of trust between medical professionals and patients.

May 16, 2023

Regular Maintenance Notification on May 31st from 6PM ~ 7PM (JST), a regular system maintenance will be performed. Please note that you may not be able to use this system during the maintenance period.

April 18, 2023

「Login failure Recovery Report」 Login failure was restored on April 18th at 2:00 PM (Japan time). We sincerely apologize for the inconvenience. We will make efforts to prevent recurrence in the future.

April 11, 2023

【About Problems with Login】As of 16:00 (Japan time) , April 11, 2023,if you log in with your email address and password stored in your PC in advance, you will be forcibly logged out when using iPax.If you are experiencing this problem, please manually re-enter the address and log in.We apologize for the inconvenience. We are working urgently to recover from the fundamental failure.

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You can try the sound source of the sample

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Below are sample sound sources for three cases. By moving the stethoscope image, you can hear the actual heart and lung sounds from each part of your body.

* Note: Earphones or headphones are required to listen to the sound source.

  • iPax

    A sample case of iPax ,Normal heart sounds and LIVE monitoring

    Function for pulse while taking auscultation will be activated. Using two Kikuzo to examine auscultation and palpation. Connect a stereo L/R converter to the device, and connect Kikuzo to each of the L/R. The pulse wave is output from the L side. You can feel the pulse on the silicon surface by increasing the volume of the L side.

    Tap the area on the anterior illustration. The chestpiece icon will move to that area and sound will be played.

    Use earphones to listen to the sound.

    When the auscultation sound stops, press the refresh mark in the lower left corner.


    JP  Pat. 6328223
    US Pat. 11,113,990

    Monitoring & Auscultation site recordings of iPax!
    The auscultation screen used by students can be monitored on the administrator's page.



    mail to:



An example of the "case list" of the sound source

\ More than 700 cases in total /

Heart sounds (iPax case)


・Normal heart sounds
・S2 respiratory split
・S2 aberrant division
・S3 Gallop
・S4 Gallop
・Sumation Gallop
・Aortic valve stenosis
・Aortic regurgitation
・Mitral valve stenosis
・Mitral regurgitation

Lung sounds (iPax case)

lung sound icon

・Normal lung sounds
・Fine Crackles
・Course Crackles
・Weezes + Ronkai
・Course Crackles + Ronkai
・Course Cluckles + Squawk + Ronkai
・Cavity breathing
・Decreased bronchial breath sounds

Other auscultation sounds

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・ Korotkoff sound (including pulse palpation function)
・ Guru sound (including metallic sound)
・Dialysis shunt sound

Case Study

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・ Heart failure
(mitral regurgitation)
・ Heart failure
(mitral regurgitation + tricuspid regurgitation + atrial fibrillation)
・Cases of chest pain
・Cases with abnormal electrocardiogram
・Rheumatoid arthritis case of MTX lung
・ Interstitial pneumonia associated with rheumatoid arthritis COPD comorbid case
・Cases of idiopathic lung disease without honeycomb lung
・A case of high MDA-5 antibody-positive dermatomyositis
・Newborn cases

\ If you want a case that is not on the list or an original case, Telemedica will create and provide the sound source /

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Message from the Supervisors

Gao Jie Jinghe profile icon Dr. Tsunekazu Takashina (MD.PhD, FACC, FAHA)

The more you use a Kikuzo speaker, the more you acquire auscultation skills.

The cardiology patient simulator "K" was developed in 1993. In 1997, its educational effectiveness of this study was reported in CARDIOLOGY. Even today, most of the university medical schools and medical colleges in Japan as well as many foreign countries have been using this simulator for their educational activities.

The advancement in diagnostic instruments using high technology has been remarkable in the last few decades. However, there is a tendency for many clinicians to become too dependent on these highly sophisticated instruments and to forget the importance of bedside clinical skills.

I believe that we have an excellent inborn sensor to recognize "organ language" and are able to detect minor changes of physical findings, such as heart sounds or murmurs of heart diseases. The Kikuzo speaker is used as an exciting teaching tool, whenever and wherever the self-learning of auscultation is needed. Please start with normal heart sounds and advance to each case at your own pace. So, you will be able to recognize various abnormal sounds and murmurs. The "Kikuzo" will be a great auscultation aide for you.

Takeshi Saratani profile icon Dr. Takeshi Saraya Department of Respiratory Medicine,
Kyorin University School of Medicine

Auscultation is an important skill for clinical practice.

Physicians can use the stethoscope whenever they want, which is an indispensable tool for discovering the etiologies and/or patients’ disease status even after the timing of modern technologies were applied. Furthermore, auscultation itself can give preferable emotional effects with the confidence for patients. Physicians should image the lung sounds for individual respiratory diseases just before performing auscultation. Learning of auscultation skills for discriminating respiratory diseases needs consideration for specific lung sounds in accordance with the anatomic location.

In this regard, the “kikuzo and its website” will provide an important and useful lung sounds for physicians, which can clearly and reproducibly learn the representative and/or essential lung sounds in general practice.

Zhiming profile icon Dr. Chiaki Hidai MD, PhD,
Professor of Nihon University School of Medicine

Auscultation is not done with the ears, but between the ears.

I remember 35 years ago when I first realized, “I have finally grasped the art of auscultation!” As a new intern I was assigned to the cardiology ward where one of my tasks was to listen to the chest sounds of a patient with five different cardiac conditions: mitral valve stenosis, mitral valve regurgitation, aortic valve stenosis, aortic valve regurgitation, and tricuspid valve regurgitation. But all I heard was a whirring sound and had no idea what it was. From that day on, every morning when I went to the ward, I spent dozens of minutes auscultating her chest. One day, about 10 days later, I suddenly heard several distinct sounds. I was able to differentiate the sound of mitral stenosis from that of aortic regurgitation. Auscultation is not something that can be understood by attempting it once. Listening carefully over and over again is what turns a noise into meaningful sounds. It is said that auscultation is not done with the ears, but between the ears. I encourage everyone to train what lies between the ears by listening carefully again and again.