Evolution of the stethoscope
XIX century
Monaural models
1816 г. – Rene Laennec |
1820-1830 гг. |
Binaural models
Proposed by Nicholas Comins in 1829 г. |
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1851 г. – Natan B. Marsh |
1870 г. – Georg Kaman |
1894 г. – Bazzi and Bianchi invented phonendoscope
Evolution of the stethoscope
XX century
1924-1926 гг. First electrical |
1926 г. – First «Bowles- |
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stethoscopes with severe |
1960. – Stethophonendoscope |
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Sprague» stethoscope |
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distortion of the sound |
«Rappaport-Sprague» |
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1960. - David Littmann new generation of the |
1990-s – electronical stethoscopes |
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stethoscopes with improved sound conduction |
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Influence of auscultation on the progress
•Correlation of sounds with the disease
•Localization of damaged organ or tissue
•Correlation of symptoms with the autopsy results
•Novel view on the nature of the illness
•Increasing role of PE
•Autonomic status of the disease
•Recognition of localized diseases
•In vivo assessment of anatomical changes
•Understanding of the evolution of the disease
In defense of the stethoscope
«Auscultation with an acoustic stethoscope can provide important, even life-saving, information. Contrary to predictions, the stethoscope is not likely to be relegated to the museum shelf in the near future. Computer technology is making it an even more useful clinical instrument»
Raymond L.H. Murphy Respiratory Care 2008; 53(3): 355-369
1906 г – first commercial electrocardiograph
Эволюция ЭХОКГ: от М-режима до 4-мерной реконструкции сердца
M-режим |
В-режим |
1990-е
3-мерная послойная |
4-мерная реконструкция сердца |
реконструкция сердца |
(в режиме реального времени) |
2000-е
Evolution of ECHO-cardiography: assessment of
biomechanics of cardiac contraction
Speckle-tracking |
Tissue Doppler |
Combination of imaging methods
Structure without function - deadman |
Function without structure– |
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phantom) |
ЭХО КГ |
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КТ
ПЭТ
МРТ
Ангиография |
SPECT |
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Innovation approach: combination of imaging methods
Diagnostics standard, evaluation of the efficacy of the treatment, prediction of complications. Combined assessment of structure and function
ПЭТ + КТ
3D ЭХО + КТ
3D ЭХО + SPECT
Imaging of coronary arteries
Coronary angiography |
Intravascular ultrasound |
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Окклюзия левой нисходящей артерии стеноз 60%