Heart problem? Smart stetho can sense it in just 15 secs

TNN & Agencies

What if heart failure can be detected early on, through a routine check-up at the doctor’s chamber instead of ECGs and other tests at a later stage? That too through an instrument familiar to all of us — the stethoscope? American health-tech firm Eko Health, in collaboration with Mayo Clinic, has launched a new, AI-powered stethoscope that can sense the heart’s reduced ejection fraction (HFrEF, which means the heart is not pumping enough blood) in 15 seconds flat. The device was recently approved by the US FDA. It has also been rolled out in several UK clinics where it correctly identified heart failure nine out of ten times.

Heart disease is the leading cause of death across the world. India has seen a 12.5% increase in heart attack cases in 2022, according to National Crime Records Bureau data. Experts say this portable device can help improve detection of cardiovascular diseases like atrial fibrillation, heart murmurs as well as heart failure.

In a press release, Dr Paul Friedman, who chairs the cardiovascular medicine department at Mayo Clinic in Rochester, said, “The ability to identify a hidden, potentially life-threatening heart condition using a tool that primary care and subspecialist clinicians are familiar with — the stethoscope — can help us prevent hospitalizations. Since a stethoscope is small and portable, this technology can be used in urban and remote locations, and hopefully help address care in underserved areas.” Mayo Clinic had used this stethoscope for a study on pregnant women in Nigeria, where the device detected twice as many cases of pregnancy-related heart failure than regular obstetric screening.

Closer home, Indian medtech startup Ai Health Highway India has come up with AiSteth which can identify heart complications in 2 minutes. Startup founder, CEO and ex-army doctor Satish Somayya Jeevannavar says the stethoscope has been used by frontline health workers to screen thousands across medical colleges and clinics in Maharashtra and Karnataka. “City folks are able to access specialist care, but it’s not possible to have a cardiologist for all the seven lakh villages in the country,” he shares. That’s where a tool like AiSteth can come in handy.

However, Dr Kunal Sarkar, director and head of cardiac surgery at Medica Superspecialty Hospital, Kolkata, says one must be thoroughly certain about the efficacy of these machines first. “The echocardiogram (echo) machine, an invaluable tool for detecting heart function, failure and other problems of the heart, is increasingly getting miniaturized. But we must bear two things in mind — accuracy and detailing. Echo is not just the picture, it involves flow analysis with a colour Doppler. Are we giving enough details in the miniaturized devices?” Both the images and the data are important, he says.

But as a primary screening tool, an AI-enabled stethoscope could be useful, say Dr Sarkar. “There are millions with rheumatic or valvular heart disease, even children with congenital heart disease, but these segments are still grossly underdiagnosed in India. The device can help screen such patients early on. However, the biggest roadblock that such a device can encounter in India is the Pre-Conception and Pre-Natal Diagnostic Techniques (PC PNDT) Act, 1994, which prohibits the use of portable echo machines except for special circumstances.”

How so? He explains that every portable echo machine (which is essentially the principle on which an AI stethoscope works) can double up as an abdominal ultrasound machine, and has the potential to be used for prenatal sex determination which is banned in India. “We still haven’t worked out how to screen patients at risk for cardiac disease while keeping a check on the misuse of such devices,” says Dr Sarkar.