English singer/songwriter Leona Lewis’ song “Bleeding Love” contains the lines:
“But I don’t care what you say, I’m in love with you / They try to pull me away but they don’t know the truth / My heart’s crippled by the vein that I keep on closing…”
It got me thinking… Perhaps she knows more about cardiology than she realises:
- Occlusion of major vein, e.g. SVC/IVC (”…the vein that I keep on closing…”)
- Decreased venous return
- Decreased cardiac output
- Decreased myocardial perfusion
- Myocardial ischaemia/infarction
- Cardiac failure (”My heart’s crippled…”)
Okay, so the literal reading of the text is a bit tenuous and I skipped a few things in the mechanism, but QED!
Today I went stethoscope hunting at the Sydney University Medical Society Bookshop. Here’s some idea of the process a typical USyd medical student goes through when choosing a stethoscope…
- The Faculty of Medicine says that we don’t need cardiology-grade stethoscopes.
- The MedSoc Bookshop staff say that we don’t need cardiology-grade stethoscopes.
- The typical Med 1 student goes ahead and buys a cardiology-grade stethoscope.
I’d asked a few friends about their stethoscopes: HC (Med 3) and PC (Med 3) both use the Prestige Clinical Cardiology, whilst FT (Med 2) uses a Littmann Cardiology III. Whilst 3M Littmann is the most popular brand of stethoscope on the market, I wanted to test out the full range of stethoscopes available at the MedSoc Bookshop before making my purchase.
MDF 797 Classic Cardiology stethoscope
I eventually settled on the MDF 797 Classic Cardiology stethoscope because of it’s quality and because it’s great value for money – only AU$16.20 more expensive than the very popular Littmann Classic II SE (a conventional stethoscope) for MedSoc Bookshop members. I won’t repeat the product features/specifications of the MDF 797 here (they’re on the MDF website), but suffice to say the design and features are comparable to the Littmann Cardiology II. It’s made in the United States, comes with a 2 year warranty and MDF offers free lifetime replacement of eartips, diaphragms and rims. Incidentally, for $24.75 more the MDF 797DD ER Premier stethoscope adds a paediatric diaphragm with bell conversion (similar to the Littmann Cardiology III), however I decided that this wasn’t necessary in my case.
MDF 797 chestpiece bell and eartips close-up
I had the chance to compare the MDF 797 to the Prestige Clinical Cardiology and the Littmann Cardiology III, and found all three to be acoustically comparable with clear loud sound transmission, and noticeably superior to standard stethoscopes. If anything, as a novice I found the flat diaphragms on the MDF and Prestige stethoscopes to be easier to use than the tunable diaphragm on the Littmann stethoscopes but your mileage may vary. So anyone out there looking for a new stethoscope, if having a brand-name Littmann isn’t essential, I recommend giving the MDF 797 serious consideration.
Hm… now that I have one, where does my stethoscope go?
Update 27 January 2014
I’d been meaning to write an addendum for some time now. Firstly, the clear eartips on the MDF stethoscopes do go yellow after a few years of use and need to be replaced. The Sydney Uni MedSoc Bookshop closed down a few years ago, sadly, being unable to compete with online stores. I’ve since purchased a Littmann Cardiology III and use this in my daily practice – the main advantages being the paediatric tuneable diaphragm and lighter weight. I can also report that cardiology stethoscopes do indeed allow you to hear murmurs that are inaudible using non-cardiology steths – particularly important as some of these grade 1–2 murmurs have been associated with endocarditis.