Heart murmurs, diagnosis made easy now by medtech startup
Consider this scenario. During a routine physical, a pediatrician hears a heart murmur. Naturally, the child is referred to a cardiologist and an appointment is scheduled for a few days (or weeks) later. The parents are terrified, but put on their brave faces.
When the appointment finally arrives, the cardiologist listens and soon diagnoses a Still’s murmur – completely harmless. The parents finally exhale, and a potentially life-changing problem simply evaporates.
This scenario plays out more than a million times each year. Understandably, pediatricians don’t want to take a chance the murmur might be serious. As a result, parents and older children face needless anxiety and the healthcare system wastes $650 million annually on unnecessary referrals.
This was the problem Robin Doroshow, a pediatric cardiologist in the Children’s National Health System, wanted to solve. She started off planning an education program. If she could teach pediatricians to recognize Still’s murmur, they could reduce the unnecessary referrals and the incredible stress these cases put on children and their parents.
“I once saw a teenager who was pulled out of soccer,” said Doroshow in a phone interview. “The kid was shaking, he was so anxious about whether he would be okay, whether he could play sports.”
Doroshow recorded around 3,000 murmurs – all different types. But she kept noticing the Still’s murmurs always sounded the same.
“I’m not just a cardiologist, I’m a trained musician,” said Doroshow. “This murmur, in different-aged and different-sized children, sounds so much the same, even the same pitch. I realized that could be used to recognize it.”
Doroshow soon contacted her colleague Raj Shekhar, principal investigator at the Sheikh Zayed Institute for Pediatric Surgical Innovation. In 2015, the two founded AusculTech Dx and began working on a device that could be used by pediatricians to quickly diagnose Still’s murmurs.
The group used Doroshow’s recordings to develop hardware and software. A small box attaches to a stethoscope on one end and an iPhone on the other. Once they’d developed a prototype, called StethAid, Doroshow and Shekhar began testing the prototype retrospectively using Doroshow’s murmur bank. In this early study, the device accurately identified Still’s murmurs.
The next step will be to test it prospectively in patients. Doroshow believes she will have no problem recruiting participants.
“Patients are really excited,” said Doroshow. “They love being recorded for research.”
The project has been funded by the Atlantic Pediatric Device Consortium and has received a Small Business Innovation Research grant from the National Institutes of Health. While the device is still a few years away from clinical use, Doroshow believes it could have a tremendous impact.
“When a pediatrician examines a child, if they hear a murmur, instead of referring to a cardiologist, they record the sound on their phone, hit the analyze button, and it tells them if it’s a Still’s murmur or not,” said Doroshow. “If it is a Still’s murmur, they’re done. They tell the parents it’s normal, and that’s the end of it.”