Connor Landgraf, the founder and CEO of Eko Devices, and designer Jason Bellet are seeking funding for a device they believe will forever change the way doctors use the stethoscope to detect heartbeat irregularities. The Silicon Valley startup is currently arranging pilot tests of its flagship product, the Eko Core, at California hospitals. The company anticipates FDA approval for its revolutionary product by 2016. The Eko Core doesn’t seek to replace the stethoscope. In fact, it aims to join forces with it.
Traditional Analog Stethoscope
Traditional stethoscope design calls for a chestpiece, two rubber-insulated tubes and ear tips. The chestpiece typically comprises a diaphragm and bell, while the tubes are composed of either stainless steel or brass. The diaphragm, which is composed of a durable and thin plastic membrane, detects the high-frequency sounds produced by murmurs and other heartbeat irregularities. Both the diaphragm and the cup-shaped bell detect the primary sounds of the heart—dubbed S1 and S2, respectively—that occur as the muscle contracts.
Doctors typically use the bell to detect low-frequency sounds, such as the “gallop” associated with heart failure. The metal tubes that convey these sounds to the ears diverge around halfway up, creating two separate channels—one for each ear. The tips funnel the sound waves directly into the practitioner’s ears. Unfortunately, the stethoscope can take years to master, and even seasoned physicians can misinterpret faint heart sounds.
Detecting Abnormal Heart Sounds
According to the Journal of the American Medical Association, approximately 4 out of every 5 physicians cannot accurately interpret the sounds generated in the chest cavity by the 12 most common heart ailments. Heart murmurs, which are caused by turbulent blood flow, are notoriously hard to hear, and worse yet, are open to interpretation. They are frequently missed in routine examinations, especially in low-income patients who view the ER as their primary source of medical care.
There are three types of murmurs, classified by when they occur in the heart’s pump cycle: systolic, diastolic and continuous. Naturally, continuous murmurs are detected and diagnosed most readily. Eko Devices co-founder Connor Landgraf is quick to point out that there is a need for digital devices that can amplify these fleeting sounds and display them in an easy-to-interpret manner, all while allowing doctors to continue to use the classic stethoscope.
The Eko Core
The Eko Core is simple in principle. It fits onto any stethoscope that features a removable chestpiece. The user then screws the chestpiece onto the Core so that the device receives input directly from the diaphragm or bell. The device then converts the sound waves generated by the patient’s body into a digital signal. Once converted, the device’s onboard software amplifies the signal and sends the data to the practitioner’s ears via the standard stethoscope eartips. This unprecedented application will allow doctors to easily discern between normal heart sounds and the tell-tale whispers that could signal impending disaster.
The technology to digitize analog signals and amplify them has existed for quite some time, but only recently has it improved to the point where the delicate sounds generated in the chest cavity can be amplified in high fidelity. This distinction is crucial because low-fidelity detection could prove more dangerous and costly than no detection at all. Low-quality reproduction of heart sounds could lead doctors to believe that murmurs exist when in fact, what they’re hearing could be nothing more than an echo of the heart itself. This misidentification could lead to costly ECG exams. Another advantage of the Eko Core is its ease of adoption. The device does much of the work, and practitioners need not alter their examination procedures to accommodate it. It’s a small device, measuring a few inches long, and it weighs only a few ounces.
The Eko Core comes with a smartphone app that receives data from it via a BlueTooth connection. This will allow medical practitioners to store their patients’ data on a secure remote server, which will increase the efficiency of medical care in general. For instance, doctors will no longer need to wait for paper medical records to arrive from other hospitals. Physicians will also be able to securely and instantaneously send a patient’s results to a specialist for a second opinion.
Perhaps the app’s strongest feature is its ability to convert analog heart sounds into visual graphs, allowing doctors to determine whether a murmur is benign or potentially harmful based on impartial waveform data. The software features an algorithm that actively monitors heart sounds and automatically detects murmurs. Time will tell whether the Eko Core is adopted by doctors, but one thing is clear: while the analog stethoscope is likely to remain the go-to cardiac diagnostic tool, it is likely to get a leg up by all manner of digital devices in the near future. These impartial diagnostic tools will help doctors make better judgments as to the potential danger of any cardiac anomaly.