Heart Songs

By Christine Gorman

Just by listening through a stethoscope to the sounds inside your chest, a well-practiced doctor can tell whether a valve in your heart is leaky, you have a touch of pneumonia in your lungs or your heart isn't pumping as much blood as your body needs. In many cases, a subtle change in the pattern of bodily noises can alert your physician to problems long before symptoms appear. Unfortunately, the art of auscultation, the technical term for listening to those sounds, is slowly dying. Seasoned physicians complain that their younger colleagues are simply more comfortable ordering high-tech--and more costly--computerized scans to make diagnoses.

Enter Dr. Michael Barrett, 57, of Temple University in Philadelphia. A cardiologist by training, Barrett started playing with his new CD burner a few years ago and got to thinking that maybe the way medical schools teach their students to use the stethoscope is all wrong. Typically, he says, students attend a basic lecture and listen to a couple of practice recordings, then they're on their own. The cardiologist suspected that they needed more repetition for their brains to assimilate the patterns dependably.

Barrett started giving his students CDs on which he had recreated the rhythm and nature of various kinds of heart murmurs. He used a mechanical simulator to produce the purest patterns (and to avoid disturbing a lot of patients). But when he asked some of the students whether they were listening to their CDs, they told him, as he recalls, "Gee, Dr. Barrett, no one listens to CDs anymore. We've uploaded everything onto our iPods."

So after consulting with a computer-savvy nephew, Barrett turned his heart recordings into iPod-readable MP3 files. They worked even better than the CDs, he found; students could see the title of each "song" they played.

How often would you have to listen to those heart sounds before you could reliably identify various types of murmurs? About 500 times, according to a study Barrett published last week in the American Journal of Medicine. The students' ability to diagnose murmurs jumped from 39% to 89% after listening to their iPods for two to three hours. A score in the 80s, Barrett says, is about as good as that of most practicing cardiologists.