When I first went to my doctor in 1995 concerning the noises I was hearing in my heart, the first thing he did was listen to my heart with a stethoscope.  His diagnoses after listening was that I had mitral valve prolapse.  

   It has been stated, that the stethoscope is the best instrument to detect MVP. The stethoscope is regarded by researchers as the most specific and sensitive method of diagnosing prolapsed valves.

    Medical educators at Alleghany University of the Health Sciences in Philadelphia, Pennsylvania were interested in testing their theory that physicians' diagnostic skills have been declining over the years.  Their finding were published in the Sept. 3 issue of the Journal of the Medical Association. It revealed that many new physicians are not adequately trained to diagnose heart problems using a stethoscope, a skill known as cardiac auscultation.

    453 physicians in their first three years of training were tested.  198 internal medicine and 255 family practice residents.  The participants listened to recordings from patients of 12 important and common cardiac events, such as heart murmurs and mitral valve regurgitation. The participants had an advantage because of the high-fidelity sound quality and the testing took place in a quiet setting.  The residents were able to recognize an average of 20% of the cardiac events, a much lower than expected average.

   88 medical students in their third and fourth year where also tested to compare their skills against the new doctors. They did not score much higher than the first group.

   Participants who played a musical instrument were more proficient at correctly identifying the cardiac events. Researchers suggest that ear training may be an important factor in training physicians.  Cardiologists, who often study by listening to audiotapes of heart sounds were 80%-90% accurate on the tests.

   The authors emphasize the importance of physicians having these skills, as they are the one that decide which patients require further diagnostic testing.  However, less than one third of internal medicine programs provide training in cardiac auscultation.  The authors conclude that medical students should be taught these important diagnostic skills.

  How do we now make sure that the doctor can really hear your heart?  In a person without symptoms a lot can be picked up by listening to the heart.  It can indicate important  intervention such as taking antibiotics for going to the dentist.  The authors recommend choosing a highly regarded physician for you primary care doctor.