Exploring cardiac diagnostics

A comparative analysis of Stethophone and electrocardiography

The esteemed electrocardiography (ECG) device has maintained its prominence as a cornerstone in cardiologic diagnostics for an extensive duration. Nevertheless, within the dynamic domain of cardiac diagnostics, the evolving technological landscape has introduced a revolutionary device, exemplified by Stethophone - an advanced digital stethoscope. Despite their shared objective of assessing cardiac health, these devices employ divergent methodologies, affording distinct perspectives on the intricacies of cardiac physiology. Stethophone, positioned as the apex of innovation, stands in contrast to the ECG, an enduring mainstay with a historical continuum exceeding a century, solidifying its role as an unwavering foundation in cardiac diagnosis. In unison, these instruments synergistically contribute to an exhaustive comprehension of cardiac dynamics, each leveraging its unique capabilities at the forefront of sophisticated cardiovascular medicine.

Stethophone is a digital stethoscope that allows for the capture and analysis of sounds from the heart, lungs, and blood vessels. With Stethophone, you can listen to and record chest sounds for sound analysis, as well as visually interpret the sounds using spectrogram and oscillogram displays. You can also securely share these recordings with your healthcare professional. It is important to note that one of the advantages of Stethophone is the ability to conduct independent examinations and record chest sounds without the need for medical personnel. This can be done anywhere and at any time, without being tied to a medical clinic or specialized equipment.

Generally, sound carries information about the structure and complex pumping activity of the heart, as well as various electrical processes within the heart.^[1] Additionally, heart rhythm is able to inform us about different types of arrhythmias, low and high heart rates, and some conduction abnormalities.^[2]

The recordings made by Stethophone will enable significant assistance for doctors conducting assessment of patients' heart sounds in the attempt to do the following:

• Evaluate heart rate and rhythm - Stethophone provides the ability to listen and visualize heart sounds so you could observe the overall picture of heart activity and heart rate.
• Assess the heart structures - through sound analysis, Stethophone helps to evaluate the condition of vital cardiac structures, such as heart valves, myocardium, and pericardium.
• Identify congenital defects - Stethophone sound quality is effective in allowing the doctors to identify congenital heart defects, contributing to early diagnosis and surgical intervention.
• Assess breathing - in addition to cardiac parameters, Stethophone allows to listen and record lungs sounds, so medical professionals could assess breathing patterns and detect pulmonary wheezing. Also, the availability of comprehensive records from both the lungs and the heart enhances the overall assessment of health, providing a more complete diagnostic picture.

Electrocardiography, widely known as ECG, involves the graphic recording of the heart's electrical activity during its cycles. This method enables the diagnosis of various cardiac abnormalities, including rhythm and conduction disturbances, hypertrophy of heart chambers, and ischemia.

The key characteristics of ECG include:

• Electrical Process Focus - ECG primarily provides insights into the electrical processes within the heart, offering a detailed analysis of its rhythm and conduction pathways.
• Limited Mechanical Information - despite excelling in electrical assessments, ECG provides less information about mechanical processes, such as valve function, blood flow, and heart contractions.
• Exclusion of Pulmonary Insights - ECG is specifically adapted to cardiac activity and does not provide information about lung functions.
• ECG can detect myocardial ischemia and infarction.

Important note: only 12-lead ECG can be informative enough to provide the diagnosis of heart chamber enlargements, myocardial ischemia, infarction, and all types of heart blocks[3]. In practice, most portable ECG-devices provide 1-6 leads ECG with reduced informativeness and are mostly useful for the detection of some arrhythmias (e.g., atrial fibrillation, premature beats).

It is important to understand that Stethophone and ECG are not competitors; instead, they complement each other in the pursuit of comprehensive cardiac diagnostics. Stethophone excels in providing detailed information about sounds associated with cardiac and respiratory functions, while ECG delves deeper into the intricate electrical activities of the heart. By combining the results of both methods, a holistic understanding of a person's heart and lung health can be obtained, ultimately enhancing the quality of patient care and diagnostic accuracy.

References:

1. Libby P. Braunwald’s Heart Disease, 2 Vol Set: A Textbook of Cardiovascular Medicine. 12th ed. Elsevier; 2021  
2. Fuster V, Narula J, Vaishnava P, et al. Fuster and Hurst's The Heart. 15th ed. McGraw Hill; 2022 
3. Azram M, Ahmed N, Lucy Leese, et al. Clinical validation and evaluation of a novel six-lead handheld electrocardiogram recorder compared to the 12-lead electrocardiogram in unselected cardiology patients (EVALECG Cardio). Eur. heart j., Digit. health. 2021;2(4):643–648. doi:10.1093/ehjdh/ztab083