<ownershipDocument>
    <schemaVersion>X0201</schemaVersion>

    <documentType>4</documentType>
<periodOfReport>2003-12-13</periodOfReport>
<notSubjectToSection16>0</notSubjectToSection16>
    <issuer>
        <issuerCik>0001144284</issuerCik>
        <issuerName>MEDICALCV INC</issuerName>
        <issuerTradingSymbol>MDCVU</issuerTradingSymbol>
</issuer>
<reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001196621</rptOwnerCik>
            <rptOwnerName>CERVELLO SALVADOR MERCE</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>PLAZA TETUAN, 19-1-B</rptOwnerStreet1>
            <rptOwnerStreet2></rptOwnerStreet2>
            <rptOwnerCity>VALENCIA</rptOwnerCity>
            <rptOwnerState>U3</rptOwnerState>
            <rptOwnerZipCode>46003</rptOwnerZipCode>
            <rptOwnerStateDescription>SPAIN</rptOwnerStateDescription>
        </reportingOwnerAddress>
            <reportingOwnerRelationship>
<isDirector>1</isDirector>
<isOfficer>0</isOfficer>
<isTenPercentOwner>0</isTenPercentOwner>
<isOther>0</isOther>
<officerTitle></officerTitle>
<otherText></otherText>
</reportingOwnerRelationship>
</reportingOwner>
<nonDerivativeTable></nonDerivativeTable>
<derivativeTable><derivativeTransaction><securityTitle><value>Option to purchase Common Stock</value>
<footnoteId id="F1"></footnoteId>
</securityTitle>
<conversionOrExercisePrice><value>1.30</value>
</conversionOrExercisePrice>
<transactionDate><value>2003-12-13</value>
</transactionDate>
<transactionCoding><transactionFormType>4</transactionFormType>
<transactionCode>A</transactionCode>
<equitySwapInvolved>0</equitySwapInvolved>
</transactionCoding>
<transactionAmounts><transactionShares><value>7000</value>
</transactionShares>
<transactionPricePerShare><value>0</value>
</transactionPricePerShare>
<transactionAcquiredDisposedCode><value>A</value>
</transactionAcquiredDisposedCode>
</transactionAmounts>
<exerciseDate><value>2004-12-13</value>
</exerciseDate>
<expirationDate><value>2008-12-13</value>
</expirationDate>
<underlyingSecurity><underlyingSecurityTitle><value>Common Stock</value>
</underlyingSecurityTitle>
<underlyingSecurityShares><value>7000</value>
</underlyingSecurityShares>
</underlyingSecurity>
<postTransactionAmounts><valueOwnedFollowingTransaction><value>7000</value>
</valueOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature><directOrIndirectOwnership><value>D</value>
</directOrIndirectOwnership>
</ownershipNature>
</derivativeTransaction>
</derivativeTable>
<footnotes><footnote id="F1">Granted pursuant to the Company's 1993 Director Stock Option Plan, which meets the requirements of Rule 16b-3.</footnote>
</footnotes>
<ownerSignature><signatureName>/s/ Traci Christensen - Attorney in Fact</signatureName>
<signatureDate>2003-12-15</signatureDate>
</ownerSignature>
</ownershipDocument>

