it has been over 200 years since the conception of the stethoscope and there have been very few improvements to its design in that time.
Fortunately, in the past 5-10 years this has started to change. One of the leaders of stethoscope production, Littmann, has developed a digital device that can amplify and even record auscultated sounds.
Less traditional startup companies have now started entering this space. Eko was one of the first companies to try and reinvent the stethoscope by offering attachments to augment the experience. This design utilizes a Bluetooth connection to a companion app that allows the user to record sounds and visualize the audio tracing of the heart (described as a "phonocardiogram").
They have continued to develop this technology and have implemented ECG tracing and artificial intelligence to their products. In 2020, Eko attained FDA clearance for detection of atrial fibrillation with 99% sensitivity and 97% specificity. They also have clearance to determine the presence of a murmur. Their next foray is into telehealth.
Similar in ambition to Eko, the Indian startup HD Medical has recently rereleased an ECG enabled stethoscope powered by artificial intelligence (AI) that was used to screen over 50,000 children across India.
They reported that this program discovered more than 90 children with congenital heart disease – 35 of which required surgery. This company has also now been FDA cleared for use in the U.S.
More recent technologies such as advanced echocardiography and cardiac MRI are going to be seeing vast improvements and expanded use cases as AI-powered software is used to enhance image quality, improve hemodynamic assessments and aid in diagnostics.
Flow dynamics during MRI will become the norm and lead to stronger understanding of structural heart disease and allow for more accurate long-term risk assessments.
Other current tools such as standard ECG and the electronic medical record are also going to see iterations and improvements that will help cardiologists provide superior, accurate and timely health care.
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