Validation of a triage tool (AI enabled Smart Stethoscope ) for screening heart sounds and murmurs using AiSteth Murmur Analysis Platform (AsMAP)- A cross-sectional study

Valvular Heart Disease (VHD) is a leading cause of cardiovascular morbidity and mortality worldwide and the resultant disease burden is only projected to increase in the coming decades. The prevalence of rheumatic heart disease, the most common form of valvular heart disease affects approximately 41 million individuals, has been on the rise in developing countries. This trend is likely linked to the growth of the young adult demographic and a reduction in premature mortality, attributed to enhanced access to antibiotics, microbiological diagnostics, and echocardiography. In developed nations, aortic valve stenosis is the most frequently encountered valvular condition, impacting around 9 million people globally, with its prevalence increasing due to an aging population and a higher incidence of atherosclerosis. Aortic regurgitation, which is linked to diastolic hypertension but not systolic hypertension, has similarly seen an uptick in prevalence in developed regions. Mitral regurgitation affects 24 million individuals worldwide, with significant variability across different countries. Primary mitral regurgitation typically results from myxomatous degeneration and mitral valve prolapse, largely influenced by genetic factors, while secondary mitral regurgitation constitutes 65% of cases and arises from dilation and heart failure. Additionally, tricuspid regurgitation has become more common in developed nations, largely due to the increased use of intracardiac pacemakers. Cardiovascular diseases (CVDs) and pathological murmurs are intricately linked, as murmurs often serve as clinical indicators of underlying cardiac abnormalities that can contribute to or signify various cardiovascular conditions. Pathological murmurs result from turbulent blood flow within the heart, which can be caused by structural defects such as valve abnormalities (e.g., stenosis or regurgitation), congenital heart defects, or other cardiac pathologies. These murmurs may be benign or indicative of serious conditions like hypertrophic cardiomyopathy, aortic aneurysms, or infective endocarditis, all of which are associated with increased risk of cardiovascular morbidity and mortality.

The examination of the cardiovascular system and the practice of cardiac auscultation serve as valuable tools in identifying murmurs. Furthermore, cardiac auscultation has proven to be beneficial in identifying valvular diseases in patients who exhibit no symptoms. Utilizing AIenabled stethoscopes presents an innovative approach to enhancing the efficiency and accuracy of pathological murmur detection. In addition, the rural regions of our nation lack sophisticated diagnostic capabilities for detecting cardiovascular diseases. Therefore, employing AI-enabled stethoscopes allows us to conduct screenings for pathological murmurs even by untrained health workers. Additionally, we can facilitate teleconsultations and arrange referrals for necessary follow-ups., enabling timely intervention to mitigate associated risks and improve patient outcomes.