Includes synopsis. / Includes bibliographical references. / Cardiac auscultation is inherently qualitative, highly subjective and requires considerable skill and experience. Computer- assisted auscultation (CAA) is an objective referral-decision support tool that aims to minimise inappropriate referrals. This study evaluated the sensitivity and specificity of 2 CAA systems, Cardioscan® and Sensi®, in detecting echo-confirmed cardiac abnormalities in 79 consecutive patients referred for assessment to a tertiary cardiac clinic. CAA demonstrated suboptimal sensitivity and specificity in detecting cardiac abnormalities in children and adults. As both systems demonstrate 100% sensitivity in detecting acyanotic heart disease, and theoretically carry significant potential in resource-limited settings, further development of current technologies to improve sensitivity and specificity for clinical applications is still warranted.