Music from the heart--in praise of auscultation. Interview by Keith Barnard.

contemporary art. I’d like an Andy Warhol, but the price is not yet quite right!” D Zelko Roncevic, chief of the paediatric cardiology department, Clinical Hospital, Mostar, says, “I always have a feeling that cardiac sounds and murmurs are a kind of music. The heart has a rhythm, and the normal heart sounds have the semblance of bass guitar and drum sounds. Some heart murmurs have a musical dimension. We even use musical terms to describe murmurs, such as crescendo and decrescendo.” Dr Roncevic believes that some murmurs are actually pleasant to listen to. “My favourite murmur is an innocent Still’s murmur,” he says, and he compares it to a musical accompaniment performed by a former Beatles musician (Figure 1). “Sir Paul McCartney’s bass guitar playing on the Sergeant Pepper album, in the song entitled ‘Getting Better,’ always reminds me of a Still’s murmur.” Still’s murmur was first described by Sir George Frederick Still, MD (1868-1941), an Englishman who was the first professor of childhood medicine. Dr Roncevic believes that Dr Still was right when he described his eponymous murmur as “a twanging sound, very much like that made by twanging a piece of tense string.” Dr Roncevic comments, “I’m sure that the tense string in question is a left ventricular false tendon. I have seen many children’s hearts with a Still’s murmur on echocardiography, and they always have false tendons.” Dr Roncevic speculated that if heart sounds and murmurs are a kind of music, it is logical that musically talented medical students and doctors might be better at cardiac auscultation than those without that particular gift, so he decided to investigate his theory. “I tested 126 medical students, from 3 universities, and 20 paediatricians. They listened to 6 prerecorded cardiac murmurs through an electronic stethoscope.” He found that those participants who could play a musical instrument or sang in a chorus identified more murmurs correctly than those who had no practical musical skills. “The heart sounds can also be a source of inspiration for Music from the Heart—In Praise of Auscultation A European Paediatric Cardiologist Believes That the Stethoscope Must Be Preserved, and That a Talent for Music May Be an Advantage Zelko Roncevic, MD, president of the Bosnia and Herzegovina Pediatric Society, has studied the relationship, in medical students, between musical talent and the ability to interpret heart sounds and murmurs. He talks to Keith Barnard, MB, BS, about his interesting theory, and why he believes that the stethoscope still has an important role to play despite modern technology. Barry Shurlock is a freelance medical writer.