PVCs are an ECG / rhythm finding, not a routine auscultation sample —
what you actually hear on the stethoscope is an irregular rhythm with a
compensatory pause, which depends on the underlying rate and is not
teachable from a canned audio clip. The card was also backed by a
synthesized sound, not a real recording. Removing both the card and
the pvc.ogg asset.
drop grunting + dead synth module
Three lung sounds that were Web-Audio syntheses now play real clinical
recordings sourced from the HLS-CMDS manikin dataset (MIT license):
- normal-vesicular.ogg
- rhonchi.ogg
- pleural-rub.ogg
Dropped expiratory grunting from the library entirely — no
openly-licensed clinical recording located across Wikimedia, Freesound
CC0, SPRSound, Pixabay, Internet Archive, or Littmann/EasyAuscultation
(all proprietary). Card is honest by omission rather than hiding a
synth behind a Play-only UI.
All seven remaining entries now use the same native <audio controls>
player (pause, seek, volume). The synth fallback branch in
renderSoundCard, the stopAllExcept synth reset loop, the script tag,
and the entire public/js/respiratorySounds.js (332 lines of Web Audio)
are removed since nothing references them anymore.
Three user-flagged fixes:
1. Cardiac sounds library expanded from 3 to 7 (from Wikimedia Commons
heart-sounds + heart-murmurs subcategories). All real recordings:
- Normal (61 bpm) [existing]
- Infant heartbeat [new — pediatric reference]
- VSD [existing]
- Mitral valve prolapse [existing]
- Still's murmur in a toddler [new — classic innocent murmur]
- Functional murmur (adult female) [new — benign flow murmur]
- PVCs [new — arrhythmia]
All with native <audio controls> (play/pause/seek/elapsed/total
work on desktop AND mobile for free).
2. APTM diagram is now full-width on every device, no longer sharing
row space with the legend on mobile:
- Image always on its own row, max-width:420px, centered
- Wrapped in an <a href target="_blank"> — tap/click opens the PNG
full-size in a new tab where browser pinch-zoom works natively
- "Tap to open full-size" hint line under the image
- Legend below uses auto-fit minmax(min(100%,260px),1fr) so it stacks
on narrow viewports without cramping
3. Synth sounds (rhonchi, pleural rub, grunting, normal vesicular — all
Web-Audio-API generated, no native controls) now have:
- Play button → kicks off playback and hides itself
- Stop button appears, lets user terminate early
- Progress bar animates over 3.2 s, resets at end
- Only one synth sound plays at a time (clicking another stops the
previous)
Four changes rolled together:
1. REAL AUDIO from Wikimedia Commons (CC BY-SA 3.0, attribution to follow
in privacy policy per Daniel). Embedded in /public/audio/ — synthesis
stays as fallback for sounds not available from Wikimedia.
respiratorySounds.js now tries the real OGG first; falls back to Web
Audio synthesis if file missing.
2. REAL APTM IMAGE from Daniel's Nextcloud share, placed at
/public/images/pe-guide/aptm.png (134 KB PNG). Replaces the inline SVG.
Kept the side legend with A/P/E/T/M colour-coded points.
3. INNOCENT MURMUR REFERENCE PANEL below the APTM diagram with the 5
classic innocent murmurs (Still's, pulmonary flow, venous hum, carotid
bruit, PPS) — age, location, character, confirming maneuver — plus
the 7 "S" criteria summary.
4. ALL-AGE RESP + CV DATA. Before: only adolescent. Now every age group
has age-appropriate resp + cv content (newborn through adolescent).
Newborn: Silverman, pre/postductal sats, duct-dependent lesion screen.
Infant: bronchiolitis, CHF diaphoresis, VSD, early CHD.
Toddler: croup/FB/epiglottitis, innocent murmur peak age.
Preschool + school-age: adult-pattern transition, sports screening.
