Current trends and perspectives for automated screening of cardiac murmurs

Although in high income countries rheumatic heart disease is now rare, it remains a major burden in low and middle income countries. In these world areas, physicians and expert sonographers are rare, and screening campaigns are usually performed by nomadic caregivers who can only recognise patients in an advanced phase of heart failure with high economic and social costs. Therefore, great interest exists regarding the possibility of developing a simple, low-cost procedure for screening valvular heart disease. With the development of computer science, the cardiac sound signal can be analysed in an automatic way. More precisely, a panel of features characterising the acoustic signal are extracted and sent to a decision-making software able to provide the final diagnosis. Although no system is currently available in the market, the rapid evolution of these technologies recently led to the activation of clinical trials. The aim of this note is to review the state of advancement of this technology (trends in feature selection and automatic diagnostic strategies), data available regarding performance of the technology in the clinical setting and finally what obstacles still need to be overcome before automated systems can be clinically/commercially viable.