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The digital stethoscope: Comeback of the phonocardiogram visually
*For correspondence: drsushrutingawale@gmail.com
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Received: ,
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This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher.
A digital stethoscope (Figure A-C) was used in November 2019 at the department of General Medicine, King Edward Memorial Hospital, Mumbai, India, to examine a 36 yr old male† who presented with breathlessness, pedal oedema and abdominal distension. Examination revealed tachycardia, tachypnoea and central cyanosis (Figure D and E), and a murmur was also audible. Chest X-ray (Figure F) showed cardiomegaly. The device helped to visually ascertain the presence of a pansystolic murmur with inspiratory and expiratory variations of the heart rate, suggestive of ventricular septal defect, when compared to the phonocardiogram of a normal heart (Video). Later, two-dimensional echo confirmed the existence of ventricular septal defect. The patient improved drastically with heart failure therapy and was discharged on medications.
- (A) The digital stethoscope. The device can be attached to any stethoscope between the rubber tubing and the chest piece, to turn a normal stethoscope into a digital stethoscope. (B) The recorded and saved phonocardiograms along with the audio clips, that can also be shared. (C) Real-time phonocardiogram being recorded on the phone when the device is placed for cardiac auscultation. (D) Cyanosis on the tongue. (E) Cyanosis on fingers of both hands. (F) Chest X-ray depicting cardiomegaly with features suggestive of heart failure.
This device is a milestone as firstly, it can aid as an educative tool, especially for undergraduate students (visual and auditory learning tool), and secondly it can be used in objective medico-legal documentation (phonocardiogram can be printed, stored and compared with future reports). This tool can also be used to screen patients for congenital and rheumatic heart diseases in rural settings with poor healthcare accessibility (tele-acoustics; referral can be planned with higher hospitals) and also to build a database to create an algorithm for artificial intelligence in auscultation.
Video available at ijmr.org.in.
Acknowledgment:
The patent for this device was approved. (PCT/IN2017/050558). Authors acknowledge Mr Adarsh K Antony, IIT Mumbai, for developing the device.
Conflicts of Interest: None.