A new US study has shown that doctors can increase the accuracy of their stethoscope skills by listening to portable sound players such as iPods and MP3s to practise recognizing sounds made by different types of heart murmur.

The study was led by Dr Michael Barrett, clinical associate professor of medicine and cardiologist at Temple University School of Medicine in Philadelphia and the results were presented yesterday at the American College of Cardiology’s (ACC) 56th annual general meeting and conference in New Orleans.

Dr Barrett and colleagues studied 149 internists who listened 400 times to five common heart murmurs for 90 minutes on iPods. The types of heart murmur they listened to were: innocent systolic, mitral stenosis, aortic stenosis, mitral regurgitation and mitral stenosis.

Other research studies show that the average doctor identifies 40 per cent of heart sounds through the stethoscope. After the 90 minutes of “listening drills”, the participants were getting an average identification success rate of 80 per cent, said Dr Barrett.

Improving doctors’ listening skills when using a stethoscope reduces diagnosis error rate and the dependence on expensive equipment and tests said the researchers.

Dr Barrett explained, “It’s important to know when to order a costly echocardiogram or stress test.”

Delegates attending the ACC conference have the opportunity to test and improve their heartbeat listening skills at workstations provided by Dr Barrett and his team at the conference.

Called Heart Song, the computer-based programme teaches users to recognise seven heart sounds by simultaneously listening to the sound of a particular heart murmur and looking at visual information on a poster.

The poster shows phonocardiograms, anatomical illustrations and photographs of the best way to position a stethoscope for “listening” to the heartbeat, or to use the correct medical term “aescultation”.

The heart sounds on the audio file are interspersed with explanations about the visual diagrams. Dr Barrett explained that listening to the heart sounds accompanied by new explanations about familiar pictures, enhanced retention and increased recognition skills.

According to Dr Barrett, Temple University now uses Heart Song to help all its medical students improve their stethoscope skills. Tests on heart listening are taken each year during their training, and since the programme was introduced they now achieve a 90 per cent recognition rate compared to 20 to 30 per cent of the general medical student and residents population.

There are various places on the internet offering medical multimedia packs or downloads to improve heart sound recognition skills. Dr Barrett’s Heart Songs are available in various forms and a typical download price is 0.99 dollars per audio file. There are also CD-packs for basic, intermediate and advance level training.

A heart murmur is an extra sound or an alteration in the sound of the heartbeat. Most of them harmless (innocent murmurs), but sometimes they can indicate, with other symptoms, that something is wrong with the way the blood is flowing into, out of or within the heart. Abnormal flows occur when a heart valve leaks or narrows, or when blood vessels in or around the heart develop problems.

Click here for American College of Cardiology.

Click here for How the Heart Works (NIH).

Click here to learn more about Human Heart Sounds & Murmurs, including audio samples (Dundee University, UK).

Written by: Catharine Paddock
Writer: Medical News Today