What Does Your Doctor Listen for With a Stethoscope?

The stethoscope has been around for nearly 200 years and is still draped across every physician’s neck or tucked into lab coat pockets. No other medical device can boast a longer life or more useful purpose.

But you may wonder what doctors are actually listening for when they place that cool metal cone against your chest. Cardiologist Umesh Khot, MD, lets us “listen in” on what your heart has to say.

“The most important assessment is whether it’s normal,” he says. “If the heart sound is normal, meaning that there’s a regular beat without any murmurs, that’s a pretty good sign of heart health.”

Sounds of trouble

1. Irregular rhythm: “Sometimes you hear an extra beat, sometimes it’s a skipped beat or it can be bouncing all over,” says Dr. Khot. “We can’t tell what the problem is that’s causing it, but we can get a sense of whether it’s in rhythm.”

2. Heart “murmurs:” A murmur itself isn’t the problem; the abnormal sounds — “whooshing” noises that vary widely — indicate a potential problem. “These signify blood flow problems within the heart, usually a problem with the valves,” Dr. Khot says. “The pitch and where it is in the heart can tell us what the valve problem is. We do additional testing to find out if it’s significant or not.”

3. Signs of congestive heart failure: These sounds are picked up by listening to the heart and lungs for both abnormal heart function and fluid in the lungs.

No matter what physicians hear through a stethoscope, it’s not enough to make a diagnosis. But such exams usually prompt further testing to uncover the cause of abnormal or irregular heartbeats.

Technological tweaks

Even the tried-and-true stethoscope is evolving with technology:

• Electronic stethoscopes now help physicians hear your heart more easily through sound amplification and noise-canceling technology.
• Telemonitoring tools allow a physician to listen to your heartbeat remotely thanks to wireless technology.
• A tool that combines the stethoscope and electrocardiogram (EKG) allows doctors to listen and watch heart rhythm simultaneously.

Still a lifesaving tool

Despite these recent developments, the traditional stethoscope, without all the bells and whistles, is an enduring part of practicing medicine, says Dr. Khot.

“There’s a lot of evidence that the findings on this exam are powerful in diagnosing how sick a patient is,” he says. “Within five or 10 minutes, you can get a quick sense of whether the person is sick and in need of emergency therapy to save their life.”