Experienced clinicians improve detection of third and fourth heart sounds by viewing acoustic cardiography.

Clinical Cardiology
Andrew D MichaelsBrian Moyers

Abstract

Clinical assessment of diastolic heart sounds is challenging. We sought to examine whether visual inspection of acoustic cardiographic tracings augments the accuracy of medical students' and physicians' detection of third and fourth heart sounds (S(3), S(4)) compared to auscultation alone. A total of 90 adults referred for left heart catheterization underwent digital precordial heart sound recordings by computerized acoustic cardiography. Two blinded, experienced readers using a consensus method determined the presence of the S(3)/S(4) on each file. There were 35 subjects from the following 5 groups participating in this study from 1 teaching institution: first-year medical students (n = 5), fourth-year medical students (n = 5), interns (n = 5), medicine residents (n = 5), cardiology fellows (n = 5), and attendings (n = 10). Using a computer module, each subject listened to the heart sounds alone and documented whether an S(3)/S(4) was present. Next, subjects listened to each recording in random order while viewing phonocardiographic tracings, and recorded S(3)/S(4) presence. An S(3) was present in 21 patients (23%) and an S(4) in 31 patients (34%) by consensus overread in 90 recordings. Baseline accuracy for auscultation of S(...Continue Reading

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Citations

Feb 18, 2014·International Journal of Cardiology·Yong-Na WenCheuk-Man Yu
Aug 16, 2017·Cardiology in Review·Michael J BarrettJohn P Finley
Jan 14, 2021·Perspectives on Medical Education·Bjorn WatsjoldGeoff Norman
Jul 13, 2021·BMC Medical Education·Fred-Cyrille Goethe DouallaChris Nganou-Gnindjio

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