While a percentage of patients who see a pediatric cardiologist at Sibley Heart Center Cardiology are coming because of complex issues, our doctors and nurses also care for many patients who are coming because of chest pain, heart palpitations or other issues but are never admitted to the hospital. Something they all have in common is that they will be evaluated with a stethoscope.

What are doctors listening for when they place a stethoscope on a patient’s chest?

A stethoscope is not terribly different from a blood pressure cuff, an echo machine or a pulse oximeter,” said Robert Campbell, MD, Sibley pediatric cardiologist. “It’s simply another tool we use to gather information about the patient.”

A stethoscope allows a physician to auscultate, or listen to, five types of sounds or noises generated by the heart and blood flowing through it:

• Heart sounds. These are simply the sound of the valves of the heart closing. A normal heart has four valves – two sets of two – that are flexible and strong, similar to plastic wrap. The valves open silently, but close with a sound like a door shutting. Sounds that differ from regular heart sounds could indicate an abnormality in the valves.
• Murmurs. Although many people have heard of heart murmurs, few know what they actually are. A heart murmur is simply the sound of turbulent blood flow in the heart. Many times the turbulent sound is “innocent,” meaning that it is not an indication of anything to be concerned about, but sometimes it’s the first sign of a more complex heart problem, such as an atrial septal defect (ASD) or a ventricular septal defect (VSD), which are holes in the septum between the chambers and common CHDs.
• Clicks. These “snappy” sounds in the heart, which sound like a flag flapping in the breeze, may indicate a valve abnormality, such as a valve that is enlarged or not as flexible as it should be.
• Rubs. A “scratchy” heart sound, reminiscent of sandpaper, could indicate inflammation around the heart or lungs.
• When doctors hear a “galloping” heart rhythm, it may indicate heart muscle dysfunction or that the muscle is being overworked.

“As a doctor, you learn how to selectively listen to each of these components one at a time, and then sum them all up to get the whole picture,” Dr. Campbell said. “You gather what you hear through the stethoscope and add it to how the patient looks, their vital signs and other data points to determine what’s going on with the patient. You can learn an awful lot by listening to the heart through the stethoscope.”

For more information about Sibley Heart Center Cardiology and our pediatric cardiology specialists, click here.