The stethoscope has a small cone which concentrates and
slightly amplifies internal body sounds while excluding external noise. One of
its major uses is in the detection of heart problems. The heart produces two
distinct sounds-e-Iubb-dup, lubb-dup, lubb- dup-which are related to the
closing of the valves inside the heart. The rate, rhythm, pitch, and intensity
of these sounds, which can be studied with the stethoscope, provide indications
of the health of the heart. The stethoscope can pick up any abnormal sounds-for
example, a rubbing scratchy noise which may indicate pericardia, an inflammationof the outer coating of the heart.
With it, too, the physician can detect murmurs-audible
vibrations produced by blood flow-and can distinguish among various types of
them. There are murmurs associated with different kinds of congenital heart
defects. Others are produced by over activity of the thyroid gland and
disappear when the gland condition is corrected. A fever or anemia may produce
a heart murmur which disappears when the anemia or fever is over- come. In
addition-and worth special note here-there are innocent murmurs. Unfortunately,
many people worry needlessly after being told at some point, perhaps during an
insurance examination, that they have a murmur even though reassured it is
"innocent." The fact is that innocent murmurs are unrelated to any physical
problem and are quite common.
They can be found in as many as 15 percent of normal healthy
adults and in an even higher percentage of normal healthy children. Such
murmurs are more readily detectable in children because they have thinner chestwalls. And some authorities are convinced that if there were sensitive enough
instruments, slight and innocent murmurs could be found in all people. Your
physician has been trained to understand the significance of various types ofmurmurs, to distinguish carefully among them, and to heed those which tell him
of existing or possibly brewing trouble.
Let him examine you and if he finds a murmur tell you
exactly what it means. If he can report that it is innocent and no reason for worry
that is exactly what he means. In addition to its value in studying the heart,
the stethoscope often is useful in revealing characteristic sounds of asthma
and of the lung disorder emphysema. Applied to the abdomen, it is often helpful
in gastrointestinal problems; it may, for example, aid in diagnosis of
intestinal obstruction. With the stethoscope, too, it is sometimes possible to
detect blood vessel problems-the existence and location of an obstruction in an
artery, for example.
