Importance of stethoscope

Valentin Fuster, M.D., Ph.D., from Mount Sinai Hospital in New York City, discusses the continuing importance of stethoscopes, which are frequently disregarded for newer technologies such as the echocardiogram. Fuster writes that the importance of stethoscopes lies in the fact that they allow physicians to physically listen to the sounds of the body. Two examples of the importance of auscultation that he had encountered in the previous 48 hours included pericardial rub in a patient with acute chest pain and fever, in whom echocardiographic images did not show pericardial effusion, and a loud P2 of the second heart sound, which an echocardiogram had been unable to detect in a patient with clear pulmonary hypertension. Despite the increase in point-of-care ultrasound training, the risk of misdiagnosis is high when used by inexperienced practitioners. “In my view, practically and economically, echocardiography systems are not — and will never be — poised to totally eradicate the stethoscope, as it is not possible for every clinician to possess a handheld echocardiography within and outside the United States,” Fuster writes. “Thus, we cannot discontinue the important training that takes place during physical exam, which can be aided through the amplified sounds of a stethoscope.”