Importance of the stethoscope

Despite advances in medical technology, the stethoscope still has an important diagnostic value, according to an editorial published online January 15 on  Journals of the American College of Cardiology.

Valentin Fuster, M.D., Ph.D., mount Sinai Hospital in New York, discusses the continuing importance of the stethoscope, which is often ignored by newer technologies such as echocardiogram.

Fuster writes that the importance of stethoscopes lies in allowing doctors to physically hear the sounds of the body. Two examples of the importance of auscultation that had been found in the previous 48 hours included pericardial massage in a patient with acute chest pain and fever, in which echocardiographic images did not show pericardial effusion, and a high P2 of the second cardiac sound, which an echocardiogram had not been able to detect in a patient with clear pulmonary hypertension. Despite increased ultrasound training at the point of care, the risk of misdiagnosis is high when used by inexperienced practitioners.
“In my opinion, practically and economically, echocardiography systems are not – and never will be – prepared to fully eradicate the stethoscope, since it is not possible for all clinicians to have portable echocardiography inside and outside the United States,” Fuster writes. “Thus, we cannot discontinue the important formation that occurs during the physical examination, which can be helped through the amplified sounds of a stethoscope.”