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What’s in a Waveform? Digital Stethoscopes Reveal More

Stethoscope WaveformDoctors have for generations diagnosed heart problems with the manual stethoscope, learning over time to recognize the characteristic sound of various heart murmurs. Heart conditions such as the atrial septal defect and the ejection systolic murmur typically sound the same from patient to patient. Still, there is a significant amount of overlap in sound between each condition, which can make definitive diagnosis difficult. When a doctor can’t identify a heart abnormality from sound alone, they must order a costly ECG. The ECG converts heart sounds into a visual waveform, and with it, doctors can more readily distinguish between heart conditions.

Even then, doctors using manual stethoscopes have to delve deeper into each abnormality to determine whether it is benign or dangerous. This may entail even more costly tests such as an MRI or ultrasound examination. With digital stethoscopes, however, such as the Thinklabs One, doctors can amplify heart sounds up to 100 times and view waveforms without the need for costly ECGs.

Physicians use a grading scale to qualify heart murmurs. A “1” on this scale is the lowest value, and a “6” is the highest. Unfortunately, a low score does not necessarily mean that the murmur is not dangerous. More important than volume is the point at which the murmur occurs in the cycle of the heartbeat, and the sounds of the heart’s normal rhythm can drown quiet murmurs out entirely. Digital stethoscopes, such as the Littmann Model 3200, have noise reduction technology that can filter out these normal sounds to highlight any abnormalities that may be lurking beneath. This technology also aids doctors in determining the true pitch of the murmur, and this can help them determine the location and nature of the murmur without ordering expensive tests.

What’s more, this money-saving technology can be inexpensive in itself. For instance, the Eko, from Eko Devices, is a stethoscope accessory that digitizes and amplifies the sounds from any manual stethoscope and then sends these sounds to the accompanying iPhone or Android app. Once there, doctors can analyze the sound at their leisure. As of June, 2014, Eko’s stethoscope attachment is in the final stages of testing, but the device is expected to retail for between $100 and $150. The Eko will appeal to doctors who prefer analog stethoscopes but who nevertheless desire a clearer picture of what’s going on in their patients’ hearts. The device automatically pairs to the physician’s smartphone, making it quick and easy to record heart sounds.

According to Eko founder and CEO Connor Landgraf, physicians will easily be able to send clips of heart sounds to other physicians for analysis, a process that would have required multiple doctor’s visits in the past, which equates to higher cost for patients. Importantly, devices like the Eko encrypt the audio data they receive before transmitting it to any smart devices as is required by U.S. Health Insurance Portability and Accountability Act regulations.

Devices like the Eko and the Thinklabs One—the latter of which can amplify heart sounds up to 100 times and fits in the palm of the hand—are revolutionizing the medical diagnostic field by providing doctors with visual confirmation of what their ears are telling them. This visual feedback will ultimately increase the accuracy of diagnosis, which will save both lives and consumer money.

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