Heart sounds: Past, present, and future from a technological and clinical perspective – a systematic review

Ayesha Azmeen, Hamid Vakilzadian, Hani Haider, Daniel H. Mathers, Reid Zimmerman, Shine Bedi, Edward L. O’Leary

Research output: Contribution to journalReview articlepeer-review


The high prevalence of cardiac diseases around the world has created a need for quick, easy and cost effective approaches to diagnose heart disease. The auscultation and interpretation of heart sounds using the stethoscope is relatively inexpensive, requires minimal to advanced training, and is widely available and easily carried by healthcare providers working in urban environments or medically underserved rural areas. Since René-Théophile-Hyacinthe Laennec’s simple, monoaural design, the capabilities of modern-day, commercially available stethoscopes and stethoscope systems have radically advanced with the integration of electronic hardware and software tools, however these systems are largely confined to the metropolitan medical centers. The purpose of this paper is to review the history of stethoscopes, compare commercially available stethoscope products and analytical software, and discuss future directions. Our review includes a description of heart sounds and how modern software enables the measurement and analysis of time intervals, teaching auscultation, remote cardiac examination (telemedicine) and, more recently, spectrographic evaluation and electronic storage. The basic methodologies behind modern software algorithms and techniques for heart sound preprocessing, segmentation and classification are described to provide awareness.

Original languageEnglish (US)
Pages (from-to)669-682
Number of pages14
JournalProceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine
Issue number6
StatePublished - Jun 2023


  • Bioacoustics
  • cardiovascular system mechanics
  • diagnostic electronic systems
  • diagnostic sampling systems
  • diagnostic screening systems
  • hemodynamics
  • medical signal processing
  • microsensors
  • physiological measurement

ASJC Scopus subject areas

  • Mechanical Engineering


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