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Quality Improvement Project

Program: Section on Cardiology and Cardiac Surgery

P2.027: Loud and Clear: Does Eko Amplifier Improve Auscultation in Obese Pediatric Patients

Saturday, September 27, 2025
1:40 PM - 2:40 PM MDT
Location: Colorado Convention Center, Four Seasons Ballroom 1 & 2
Poster Presentation
Purpose/Objectives: Cardiac auscultation can be difficult in obese patients due to limitations inherent to the stethoscope. Digital stethoscopes have been shown to improve auscultation in obese adults but there is no data supporting this in Pediatrics. Our study aims to demonstrate that there is an improvement in the clarity and loudness of cardiac auscultation in obese pediatric patients when the 3M Littmann ® CORE amplifier (Eko) is enabled.

Design/Methods: Pediatric patients seen in cardiology clinic were enrolled based on BMI (Overweight, 85-95th %; Obese, >95th %, Severely Obese, >120th %- or >35kg/m2). All patients were auscultated in traditional locations using 3M Littmann ® CORE in analog and amplified modes. Providers completed a survey about clarity and loudness of auscultation. Likert scale for Clarity (Not Usable, Poor, Acceptable, Good, Excellent) and Loudness (Inaudible, Quieter than Ideal, Acceptable, Ideal, Louder than Ideal) were utilized for both methods. Adequate auscultation was defined as either Acceptable, Good, Excellent, or Ideal. Comparisons were made between the two methods using standard statistical methods.

Results: We enrolled 44 overweight or obese patients (1 Overweight, 15 Obese, 27 Severely Obese.) The data showed that providers were more likely to classify the loudness and clarity as adequate when using the Eko amplifier (p < 0.0001 for both). Neither loudness nor clarity were influenced by other demographics (gender, obesity score or age).

Conclusion/Discussion: Our study demonstrates that Eko digital stethoscope with use of the amplifiers improve not only loudness, but also clarity when auscultating overweight and obese pediatric patients compared to traditional analog auscultation. Future direction is to to implement a clinic wide use of this novel technology (digital stethoscope) when evaluating overweight and obese patients and evaluate if this improved auscultatory ability improves diagnostic/ therapeutic decision making.