However, detailed auscultation alone can take up to 10 minutes 3. History taking and a detailed physical examination, including auscultation, are considered essential parts of clinical examination. Auscultation of the respiratory system is non-invasive, safe, inexpensive and easy-to-perform. The use of the stethoscope is considered an essential skill in the medical profession and is often chosen for its’ ease of use, as well as for its’ appearance and reputation 2. Laënnec invented the most common symbol of medicine: the stethoscope 1. Only in resource limited settings, with a high prevalence of disease and in experienced hands, lung auscultation has still a role. When better diagnostic modalities are available, they should replace lung auscultation. Lung auscultation has a low sensitivity in different clinical settings and patient populations, thereby hampering its clinical utility. Results are limited by significant heterogeneity. Abnormal breath sounds are highly specific for (hemato)pneumothorax in patients with trauma. LRs and AUC of auscultation for congestive heart failure, pneumonia and obstructive lung diseases are low, LR− and specificity are acceptable. For 34 studies the overall pooled sensitivity for lung auscultation is 37% and specificity 89%. A meta-regression analysis is performed to reduce observed heterogeneity. Main outcomes are pooled estimates of sensitivity and specificity with 95% confidence intervals, likelihood ratios (LRs), area under the curve (AUC) of lung auscultation for different pulmonary pathologies and breath sounds. Studies concerning adult patients with respiratory symptoms are included. This meta-analysis aims to evaluate the diagnostic accuracy of lung auscultation for the most common respiratory pathologies. However, there is much debate about the diagnostic accuracy of this instrument. Lung sounds.The stethoscope is used as first line diagnostic tool in assessment of patients with pulmonary symptoms. Physical signs in patients with chronic obstructive pulmonary disease. You can learn more about how we ensure our content is accurate and current by reading our editorial policy. We link primary sources - including studies, scientific references, and statistics - within each article and also list them in the resources section at the bottom of our articles. Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. Some warning signs of heart failure include: Heart failure is a chronic condition in which the heart does not pump enough blood to meet the body’s needs. Those with COPD often have audible wheezes or longer periods of exhalation with decreased breath sounds. Chronic obstructive pulmonary disease (COPD)ĬOPD refers to a group of diseases that cause breathing-related problems due to airflow blockages. Lungs affected by pneumonia may make bubbling, crackling, and rumbling sounds during inhalation. A viral, bacterial, or fungal infection can cause pneumonia. Pneumonia is an infection of one or both lungs, which causes the air sacs found in the lungs to fill up with pus or fluid. It is essential to listen for sounds characteristic of pneumonia, since bronchitis can sometimes develop into pneumonia. Those with bronchitis may wheeze or have rhonchi that improves with coughing. It usually develops due to a viral infection. Bronchitisīronchitis occurs when the lungs’ airways swell and produce mucus in the lungs. People with asthma may have normal vesicular breath sounds but with prolonged expiration, or they may have audible wheezes in various places around the chest. Below are some conditions that can cause these sounds: AsthmaĪsthma is a chronic condition that causes airways to become inflamed and narrowed. Listen for the quality and intensity of the breath sounds, as well as for the presence of abnormal sounds, or discrepancies between the sounds on either side of the chest.Ībnormal or adventitious breath sounds can be a sign of an underlying condition. It is important to hear at least one complete breath cycle at each site. Again, listen for one full breath in each position, moving the stethoscope from the top of the chest and working down. If they are lying down, roll them onto the other side.
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