![]() Barrett is a consultant for the American College of Cardiology Foundation. Thomas, Temple University School of Medicine.Įditor’s Note: Reporters are welcome to observe the physician study and session at the ACC as well as medical students listening to heart sounds via iPods at Temple University.ĭisclosure: Dr. Barrett M.D., Archana Saxena M.D., Katherine A. Page Heart Murmur Sound Types S1: The first heart sound, a low-pitched sound caused by the closing of the mitral and tricuspid valve. Consequently, he advised the ACC to make the CDs car-friendly and about the length of an average commute.Ībstract (MS Word): Rapid Rise in Cardiac Auscultation Skill After a Single 90 Minute Intervention: A Quality Improvement Study, By Michael J. “There are two times when a busy practitioner can learn a new skill: at professional meetings and during their work commute,” observed Barrett. He foresees a day in the near future when doctors are listening to heart sounds during their work commute. An S3 is most commonly associated with left ventricular failure and is caused by blood from the left atrium slamming into an already overfilled ventricle during early diastolic filling. Thanks to a partnership with the American College of Cardiology, Barrett’s heart sounds can now be accessed online and are available on CD. While present in normal subjects up to the ages of 20-30, they represent pathology in older patients. Since the release of Barrett’s first study with medical students, the demand for recordings of heart sounds has been intense. After listening repeatedly to the audio files, students’ skills are tested. Temple University School of Medicine, where Barrett teaches, recently started a four-year curriculum on cardiac auscultation that relies on different types of simulators, including iPods, to teach medical students this important but vanishing skill.įor each year of medical school, heart sounds are posted online, allowing students to download them to an iPod or mp3 player. After listening 400 times to each sound, they will be tested again to measure their improvement. ![]() ![]() After the physicians’ baseline stethoscope skills are tested, they will receive an iPod loaded with various heart sounds. “You don’t build this proficiency by osmosis,” Barrett said.īarrett will lead another study of physicians, this time cardiologists, at the American College of Cardiology meeting in New Orleans on March 25 and 26 at 9 a.m. Listening to the heart, known as cardiac auscultation, is, Barrett believes, a technical skill and therefore best learned through intensive drilling and repetition, not by traditional methods, usually a classroom lecture or demonstration in medical school and then on the job. Requirements for residents and other specialists are sure to follow.” “Plus, internists are now tested on this skill for board recertification. “It’s important to know when to order a costly echocardiogram or stress test,” said Barrett. Note: Since P2 is measured relative to A2, causes for lower A2 intensity should be ruled out.Proficiency with a stethoscope - and the ability to recognize abnormal heart sounds - is a critical skill for identifying dangerous heart conditions and minimizing dependence on expensive medical tests.DDx: pulmonary hypertension (most common), ASD will also increase P2.Increased intensity of P2: P2 louder than A2 at pulmonic region (left parasternal, intercostal space 2).
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