Patients rely on their physicians to recognize signs of trouble, yet for common heart murmurs, that ability is only fair at best. Fortunately, the solution is simple: listening repeatedly. In fact, intensive repetition — listening at least 400 times to each heart sound — significantly improved the stethoscope abilities of doctors, according to a study presented today at the American College of Cardiology's annual meeting.
After demonstrating last year that medical students greatly improved their stethoscope skills by listening repeatedly to heart sounds on their iPods, lead investigator Michael Barrett, M.D., clinical associate professor of medicine and cardiologist at Temple University School of Medicine and Hospital, set out to test the technique on practicing physicians.
During a single 90-minute session, 149 general internists listened 400 times to five common heart murmurs including aortic stenosis, aortic regurgitation, mitral stenosis, mitral regurgitation and innocent systolic murmur. Previous studies have found the average rate of correct heart sound identification in physicians is 40 percent. After the session, the average improved to 80 percent.
Proficiency with a stethoscope — and the ability to recognize abnormal heart sounds — is a critical skill for identifying dangerous heart conditions and minimizing dependence on expensive medical tests.
"It's important to know when to order a costly echocardiogram or stress test," said Barrett. "Plus, internists are now tested on this skill for board recertification. Requirements for residents and other specialists are sure to follow."
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