News
We provide a selection of recent articles on the art and science of heart auscultation, resources and the latest teaching methods. If you would like to contribute please email the author at teachingheartauscultation@gmail.com.
Cardiac Sound assessment with AI in 2023
Artificial Intelligence and Machine Learning Cannot Replace Human Auscultation Skills
Contributed by Robert P-C Chen MD FRCPC, Pediatric Cardiologist, IWK Children’s Hospital, Halifax, Nova Scotia.
Posted November 2023
Artificial intelligence (AI) and machine learning (ML) can potentially enhance the diagnosis and management of cardiac diseases. AI and ML can analyze heart sounds and murmurs which provide valuable information about cardiac structure and function and help detect various valvular and congenital heart diseases. However, the interpretation of heart sounds and murmurs requires skill and experience. Therefore, AI and ML to assist or automate the auscultation process may seem appealing, especially in the era of telemedicine and digital health.
Unfortunately, there are limitations associated with the use of AI and ML for the purposes of assessing heart sounds and murmurs including…
200 Years of the Stethoscope
John Finley MD & Allan Marble PhD
Historic display items courtesy of Dalhousie History of Medicine Society
Recently noted:
Barrett MJ, Mackie AS, Finley JP: Cardiac Auscultation in the Modern Era: Premature Requiem or Phoenix Rising? Cardiology in Review 2017; 25: 205–210.
A review of teaching methods including the potential educational role of hand held ultrasound.
Draper J, Subbiah S, Bailey R, Chambers JB. Murmur clinic: validation of a new model for detecting heart valve disease. Heart 2019;105:56–59.
Comparison of physical examination and technologist directed ultrasound.
Dykes JC, Kipps AK, Chen A, Nourse S, Rosenthal DN, Tierney ESS. Parental Acquisition of Echocardiographic Images in Pediatric Heart Transplant Patients Using a Handheld Device: A Pilot Telehealth Study. J Am Soc Echocardiogr 2019; 32:404-11.
Pinto C, Pereira D, Ferreira-Coimbra J, Portugues J, Gama V, Coimbra M. A comparative study of electronic stethoscopes for cardiac auscultation In: 2017 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, July 2017, pp.2610-2613.
Bank I, Vliegen HW, Bruschke AVD. The 200th anniversary of the stethoscope: Can this low-tech device survive in the high-tech 21st century? Eur J Cardiol 2016; 37 (47): 3536–3543.
Fuster V. The stethoscope’s progress. Very much alive and very necessary. J Amer Coll Cardiology 2016; 67(9): 1118-1119.
Metkus TS. The physical examination and the fifth maneuver. J Amer Coll Cardiology 2015; 66 (18):2048-2051.
Commentary on the importance of physical examination in an age of increasing dependence on imaging.
Mcgee S. Etiology and Diagnosis of Systolic Murmurs in Adults
Amer J Medicine 2010;123(10),913-921.e1.
A comparison in 375 patients of their physical findings to transthoracic echocardiography, exploring the associations between echocardiography and systolic murmurs and investigating the diagnostic accuracy of physical examination for pathologic murmurs.
Mckinney J, Cook DA, Wood D, Hatala R. Simulation-based training for cardiac auscultation skills: systematic review and meta-analysis. , J General Internal Medicine 2013; 28(2), 283-91.
This review examines the effectiveness of simulation-based medical education (SBME) for training health professionals in cardiac physical examination.
Leggett ME, Toh M, Meintjes A, Fitzsimons S, Gamble G, Doughty RN. Digital devices for teaching cardiac auscultation – a randomized pilot study. Med Educ Online 2018; 23(1): 1524688
Galusko V, Khanji MY, Bodger O, Weston C, Chambers J, Ionescu A.
Hand-held Ultrasound Scanners in Medical Education: A Systematic Review. J Cardiovasc Ultrasound 2017;25(3):75-83
Stokke TM, Ruddox V, Sarvari SI, Otterstad JE, Aune E, Edvardsen T. Brief group training of medical students in focused cardiac ultrasound may improve diagnostic accuracy of physical examination. J Am Soc Echocardiog 2014;27:1238–1246
Finley JP, Caissie R, Nicol P. International trial of online auditory training programme for distinguishing innocent and pathological murmurs. J Paediatr Child Health. 2015 Aug; 51(8):815-9
#ICEicle: The Lost(?) Art of the Cardiac Physical Exam – #FOAMed Resources
