when a doctor uses a stethoscope what is being monitored

Have you ever wondered why every doctor places a stethoscope on your chest? What is its function? When a doctor uses a stethoscope, what is being monitored?

When a doctor uses a stethoscope, he can listen to the heartbeat of his patient. With the stethoscope, the sound generated by heartbeat and blood flow is monitored. Doctors use this tool to examine the heartbeat sound whether the patient is sick or not.

In this blog post, we answer all your questions and clear your confusion about the topic.

when a doctor uses a stethoscope what is being monitored

Inspect the patient going through any disease:

Basically, a key challenge for a doctor is to find out what’s happening inside the human body without resorting to opening it up. For instance, an x-ray can only provide you with a still image. There’s no way to know what’s going on inside the body in real-time with it. Only the tool stethoscope can help in examining the heart sounds.

To determine if the body is functioning normally:

 A stethoscope determines whether the heart valves are functioning properly by listening to the heart sounds. Further, Stethoscopes are still important screening devices in modern times. When doctors listen to a person’s heart or lungs, they may order a more precise test to confirm the findings.

To take a further step for proper tests:

Thus, stethoscopes allow doctors to make critical decisions based on vital signs if someone needs to be hospitalized for further lungs and heart tests or treatment. 

What Sounds Of The Heart Are Monitored: 

Normal heartbeat sound:

With a stethoscope, one can usually hear 2 sounds when listening to the heart. Blood is pushed only in one direction by four valves in the heart. When the valves shut, they make a sound. In a normal heartbeat, two distinct sounds can be heard, usually called lub-dub. The closing and opening of valves. 

Murmurs sound:

Some patients with the disease have additional vibrations that lead to other distinct sounds. Or the arteries in some people may be narrow, resulting in murmurs. Again, it indicates that there is an obstruction of blood flow within the heart.

An Unsettling Sound:

There are times when the doctor notices an extra beat or skip, although they cannot tell what exactly is causing it. But they have come to the point that something’s wrong. To find out the results, more sophisticated testing is done. 

Congestive heart: 

Asthmatic patients deal with wheezes and whistling in their breath, which means their lungs are congested or fluidized. The stethoscope also helps to figure it out. Doctors follow proper tests for abnormal heart function and fluid in the lungs when they hear congestive sounds in the heart and lungs. 

When irregular or troubled heartbeats are detected through such stethoscope exams, doctors usually conduct further sophisticated testing. 

Which conditions can cause irregularities in the sound of the heart?

Generally, the Closure of heart valves produces normal heart sound. Mitral and tricuspid valve closure produces the first heart sound (S1). Then, the aortic and pulmonic valve closing produces another heart sound (S2).

The presence of abnormal heart sounds and murmurs often indicates that structural heart disease is present. The term is used to describe either a problem with the heart muscles or the heart valves.

There are therefore three possible mechanisms of abnormal heart sounds given down below:

  1. Abnormal ventricular filling:

The first mechanism for abnormal heart sound occurs when ventricular filling becomes abnormal. The S3 sound occurs in the early diastole when inflowing blood hits a bloated ventricle. And S4 is the result of blood flowing into a stiff ventricle as a result of atrial contraction in the late diastole

  1. New abnormal event:

The second mechanism for abnormal heart sounds is when the heart experiences a new abnormal event. Such as irregular heartbeats, too fast, too slow, or conducted via an abnormal electrical pathway through the heart.

  1. Incorrect timing:

The third mechanism causing abnormal heart sounds is incorrect timing of otherwise normal cardiac events. For example, abnormal splitting of the second heart sounds S2. 

Types of abnormal heartbeat sounds:

Some of the types of abnormal heartbeat sounds are given below:

Tachycardia: 

As the name implies, tachycardia is a fast heartbeat and is the first abnormal heart sound. Tachycardia is characterized by heartbeats that run over 100 beats per minute. While the normal heartbeat rate is 60-100 beats.

Tachycardia is further divided into three types:

  1. Supraventricular tachycardia:

This type is caused by abnormal electrical signals that come from the above ventricles. As a result, Atria occurs in the heart chambers above the pulmonary veins. A person with this type of heart rate has a fast heart rate.

  1. Ventricular tachycardia:

Ventricles are the lower chambers of the heart where this type develops.

  1. Sinus tachycardia:

When experiencing this type of hypertension, the heart rate usually rises as he feels sick, excited, or afraid. However, it takes some time for the heart rate to return to normal in this type of tachycardia.

Bradycardia:

Bradycardia is another type of abnormal rhythm in the heart. Your heartbeat rate will be below 60beats per minute with this type of heartbeat which is very slow. Bradycardia occurs when the electrical signals that travel from the ventricles to the atria are disturbed. 

A good physical condition, however, means it’s not a problem if the heartbeat is slow. 

Premature contractions:

This type of irregular heartbeat causes extra, early or skipped heartbeats. These appear in either the top or bottom chambers. Premature contractions cause the heartbeat to be so weak that it is difficult to hear or feel.

Ventricular fibrillation:

In this type of heart disease, the heart becomes immobile and cardiac detention occurs. It arises in the heart’s ventricles when they cannot pump blood to the body and brain. Therefore, this situation should be seriously considered and addressed immediately. If it is not properly treated, it may cause death.

What are the factors that cause changes in your heart’s sound?

Some of the common factors that cause changes in one’s heart sounds are given down below;

  • The lipid cholesterol.
  • Blockage of the arteries. 
  • Recovering from heart surgery.
  • A change in the muscles of your heart following an injury.
  • Blood pressure.
  • Low potassium.
  • A few other cardiac abnormalities.
  • Lungs filled with fluid.

What else can a doctor detect with a stethoscope?

Pulmonary examination:

Not only can you listen to your heart with a stethoscope, but you can also listen to your lungs to see how freely air flows in and out. If the lungs are congested or fluidized, the stethoscope helps in figuring out. 

Intestinal examination:

Additionally, the stethoscope helps check the digestive tract after an operation to determine if it is functioning properly. In different spots of the abdomen, the doctor can listen for bowel sounds for several minutes.

Checks blood pressure:

In addition, it helps doctors when they take someone’s blood pressure. For example, if you have a stethoscope on your artery and a cuff around your arm, a doctor or nurse can listen to your blood pressure by pumping it up.

Observe infant’s heartbeat:

The stethoscope is also used at home to hear the unborn baby’s heartbeat after 19-20 weeks of pregnancy. As a result, you don’t need to visit the clinic repeatedly.

In modern days rapid advances in technology have taken place. However, it does not mean the stethoscope is no longer useful. On the contrary, the rubber pieces still serve as important screening tools today. 

A longer life or more useful purpose can’t be matched by any other medical tool. Thus, the stethoscopes are doped on every doctor’s neck and coat. 

How is the stethoscope used?

Step 1: Placement of the stethoscope 

The stethoscope has two parts. The air buds at the top and the diaphragm at the bottom. To use the stethoscope in the right way, one should place the stethoscope into the ears in the right way around. 

Step 2: Earbuds placement: 

The earbuds are placed frontwards, not towards yourself. Otherwise, the proper sounds won’t be heard. Also, there may be interference too. 

Step 3: place the diaphragm for 1 minute:

Further, the diaphragm must be placed on the skin not over any clothing. Otherwise, that can cause interference too and it would be hard to hear for the doctor as well. So using the stethoscope you need to place the diaphragm onto the patient’s skin for one minute and then remove it.

Step 4: detect the heartbeats: 

Lastly, after hearing the heart sounds, one can come up with the results. However,  stethoscopes are not only designed to listen to heart sounds but also any abdominal sounds. Also, it can be used at the front and the back where you might even hear some crackles or wheezing. 

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Muhammad Bilal Qayyum

MBBS from Taishan Medical University and currently working in Bahawal Victoria Hospital. The blog is a great resource for both novices and experienced users when it comes to stethoscopes. As I studied and practiced, I evaluated various models on the market, which led me to become an expert in stethoscopes.

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