Stethoscope vs EKG

[allthequestions]

Are there any diseases that can be picked up with a stethoscope but not EKG? I.e. intensity of S1 or S2 or any murmur abnormalities that would not also show up as an abnormality on an EKG?

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[Marcus Brody]

lol wut

 

[Baron Samedi]

Are there any diseases that can be picked up with a stethoscope but not EKG? I.e. intensity of S1 or S2 or any murmur abnormalities that would not also show up as an abnormality on an EKG?

Any acute valvular abnormality will be picked up on auscultation much sooner chronologically than on EKG. With EKG your looking for myocardial electrical activity -- so for example, if you had a mitral vegetation, you'd hear a murmur before you saw an abnormal EKG in the form of left ventricular hypertrophy.

 

[Caesar]

EKG is electrical conduction.

Auscultation picks up all sorts of things. You can't really hear an MI with a scope. But you can't necessarily see a structural defect on an EKG. PDA comes to mind. Valve dx don't always have EKG findings.

 

[allthequestions]

Any acute valvular abnormality will be picked up on auscultation much sooner chronologically than on EKG. With EKG your looking for myocardial electrical activity -- so for example, if you had a mitral vegetation, you'd hear a murmur before you saw an abnormal EKG in the form of left ventricular hypertrophy.

Wow! I just started reading about the cardiac cycle. So if someone has mild mitral stenosis following a rheumatic fever, is the stethoscope going to be the primary tool that you'll use to diagnose his stenosis? And once someone is diagnosed with some murmur that does not involve any hypertrophy or arrythmia, is there any pharmacologic treatment that would improve his condition? Or does the management of such diseases involve mostly "monitoring and followup to see if it gets worse"? By the way I had something as a child and it was definitely picked up on EKG.

 

[MossPoh]

Seems like a perfect opportunity to learn how to use your school's library website to me.

Come back and tell us what you find.

 

[allthequestions]

EKG is electrical conduction.

Auscultation picks up all sorts of things. You can't really hear an MI with a scope. But you can't necessarily see a structural defect on an EKG. PDA comes to mind. Valve dx don't always have EKG findings.

I just read on wiki that Echocardiograph is what they use for PDA! Also what about the PHONOCARDIOGRAM?! Does it not allow you to get textbook results of someone's heart sounds without having to use a stethoscope?

 

[allthequestions]

Seems like a perfect opportunity to learn how to use your school's library website to me.

Come back and tell us what you find.

From having read the chapter on the cardiac cycle I can tell that it is much easier to learn to classify different heart sounds with relevant pathophysiology than to be able to distinguish those sounds with a stethoscope. But what's the purpose of learning to use a stethoscope when a machine can do it at least as well as anybody:
http://en.wikipedia.org/wiki/Phonocardiogram

 

[Caesar]

an ECHO is not an EKG....

Not sure if serious anymore....

 

[Caesar]

From having read the chapter on the cardiac cycle I can tell that it is much easier to learn to classify different heart sounds with relevant pathophysiology than to be able to distinguish those sounds with a stethoscope. But what's the purpose of learning to use a stethoscope when a machine can do it at least as well as anybody:
http://en.wikipedia.org/wiki/Phonocardiogram

your homework is to find a scholarly article about the sensitivity and specificity of a phonocardiogram for MVP and aortic regurg.

 

[allthequestions]

an ECHO is not an EKG....

Not sure if serious anymore....

I did not mean to imply that I don't know the difference between Echo and EKG. I just found on wiki that Echo is the primary diagnostics tool for diseases of the valve and PDA. I did not want to mention Echo, because it looks very complicated to me in contrast with EKG. But I guess my question is: are there any diseases where a stethoscope is the primary diagnostics tool and whether early diagnostics of those diseases influences (pharmacologic) management? I just noticed you wrote that a phonocardiogram might not always work. But my time in the library is done as it closes at 11:00).

 

[Rendar5]

I did not mean to imply that I don't know the difference between Echo and EKG. I just found on wiki that Echo is the primary diagnostics tool for diseases of the valve and PDA. I did not want to mention Echo, because it looks very complicated to me in contrast with EKG. But I guess my question is: are there any diseases where a stethoscope is the primary diagnostics tool and whether early diagnostics of those diseases influences (pharmacologic) management? I just noticed you wrote that a phonocardiogram might not always work. But my time in the library is done as it closes at 11:00).

Stethoscopes play no role in the following scenario only:

You're a cardiology specialist with additional training on sonography, are willing to do both transthoracic echo and transesophageal echo in the office or wherever you go in the hospital on every single patient you see, you like lugging that machine around with you, and you happen to have an anaesthesiologist following you around for procedural sedation for transesophageal echos.

I'm trained in ultrasonography, and even I use my stethoscope all day every day.

 

[allthequestions]

Cool. Thanks for the responses.

 

[Dral]

I did not mean to imply that I don't know the difference between Echo and EKG. I just found on wiki that Echo is the primary diagnostics tool for diseases of the valve and PDA. I did not want to mention Echo, because it looks very complicated to me in contrast with EKG. But I guess my question is: are there any diseases where a stethoscope is the primary diagnostics tool and whether early diagnostics of those diseases influences (pharmacologic) management? I just noticed you wrote that a phonocardiogram might not always work. But my time in the library is done as it closes at 11:00).

Echos aren't THAT much more complicated than an EKG...at least to perform, they take a bit more time and a person who knows what they're doing. Probably not all that much more difficult to interpret either (can't say I rock at interpreting either).

They compliment each other. Anyone that comes in with ACS/MI will probably have an echo done sooner rather than later. The EKG will most likely pick up the MI, the echo will help tell how much 'damage has been done'.

 

[newdoc2013]

it all depends on what you're looking for.

useing a stethoscope is the cheapest but has a high interrater variability and you can miss things that are obvious on echo.

ekg is good for conduction abnormalities / some pericardial manifestations / some lung problems and even sometimes stroke.

echo shows wall motion changes, confirms valve pathologies often picked up first by ascultation and can estimate pressures

heart cath can tell you pressures in the heart

each of these diagnostic testing modes have their place in medicine.

 

[mmmcdowe]

Pneumonia






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