Development and Acoustic Analysis of a Speaker-Output Stethoscope for Low-Cost Clinical Applications
Downloads
This study addresses the limitations of traditional stethoscopes, which are constrained by their single-user design, dependence on auditory acuity, and susceptibility to background noise. These limitations hinder collaborative learning and diagnostic accuracy, particularly in noisy environments or during infectious disease outbreaks. The aim of this work is to develop a low-cost, speaker-output digital stethoscope that enables multiple users to simultaneously listen to heart sounds, improving both clinical training and infection control. The main contribution of this study is the integration of a conventional analog stethoscope with a high-sensitivity microphone preamplifier, an external speaker, and digital signal processing (DSP) algorithms. This configuration allows the amplification and filtering of heart sounds, enabling group auscultation without the need for earpieces. The device casing is constructed from High-Pressure Laminate (HPL) sheets and multiplex wood panels, while acoustic foam is used to reduce noise interference. Heart sounds are captured via a microphone, amplified, and processed using Fast Fourier Transform (FFT) and band-pass filtering (20–150 Hz) to isolate the key frequencies. The system was tested in a quiet clinical setting, and the resulting audio was analyzed for clarity and frequency spectrum. The prototype successfully captured heart sounds, with a dominant spectral peak around 97 Hz, consistent with the primary frequency of heartbeats. It also clearly identified the first (S1) and second (S2) heart sounds. However, ambient noise affected sound clarity, indicating the need for further noise reduction. Despite this limitation, the device successfully enabled group auscultation. In conclusion, the speaker-output stethoscope offers an affordable and effective alternative to traditional auscultation, enhancing medical training and improving infection control. Although noise reduction requires further refinement, the system demonstrates strong potential for application in clinical and educational settings, particularly in low-resource environments
[1] R. Laennec, De L’auscultation Médiate, Paris: J.-A. Brosson & J. S. Chaudé, 1819.
[2] Analog Devices, “Introduction To Digital Stethoscopes And Electrical Component Selection Criteria,” [Online]. Available: Https://Www.Analog.Com.
[3] A. Taye Et Al., “Design Of An Ai-Enhanced Digital Stethoscope: Advancing Auscultation Accuracy,” Arxiv Preprint Arxiv:2412.14206, 2024.
[4] A. J. Hansen Et Al., “Development And Experimentation Of A New Digital Communicating And Diagnosing Stethoscope,” Procedia Computer Science, Vol. 83, Pp. 1154–1159, 2016.
[5] A. A. Ghosh Et Al., “Cardiac Anomaly Detection Using Digital Auscultation,” Ijert, Vol. 5, No. 6, 2016.
[6] J. Schneider, “Tele-Auscultation And The Future Of Clinical Listening,” Newborn, Vol. 7, No. 1, Pp. 42–49, 2023.
[7] Wired, “The Bluetooth Stethoscope Designed For Home Use,” [Online]. Available: Https://Www.Wired.Com.
[8] Giordano N, Rosati S, Balestra G, Knaflitz M. A Wearable Multi-Sensor Array Enables The Recording Of Heart Sounds In Homecare. Sensors. 2023;23(13):6241. Doi:10.3390/S23136241
[9] Guo B, Tang H, Xia S, Wang M, Hu Y, Zhao Z. Development Of A Multi-Channel Wearable Heart Sound Visualization System. J Pers Med. 2022;12(12):2011. Doi:10.3390/Jpm12122011
[10] Digital Engineering 24/7, “Rethinking The Stethoscope,” 2017.
[11] J. Cheung Et Al., “Digital Stethoscope Design,” University Of Guelph, 2008.
[12] T. Kim Et Al., “Shared Auscultation In Medical Training Using Audio Streaming Stethoscopes,” Ieee Access, Vol. 9, 2021.
[13] C. Huang Et Al., “Patient Engagement Through Audio Feedback: A New Role For Digital Stethoscopes,” Bmj Innovations, Vol. 6, 2020.
[14] Cdc, “Infection Control Recommendations For Healthcare During Covid-19,” 2020.
[15] T. E. Thompson, “Acoustic Isolation Techniques For Covid-19 Medical Devices,” J. Hosp. Infect., Vol. 105, 2020.
[16] Mohamed N, Kim H-S, Kang K-M, Mohamed M, Kim S-H, Kim J-G. Heart And Lung Sound Measurement Using An Esophageal Stethoscope With Adaptive Noise Cancellation. Sensors. 2021;21(20):6757. Doi:10.3390/S21206757
[17] Zhang A, Et Al. Classification Of Children’s Heart Sounds With Noise Reduction Methods. Front Med Technol. 2022;4:854382. Doi:10.3389/Fmedt.2022.854382
[18] Pauline Sh. A Robust Low-Cost Adaptive Filtering Technique For Denoising Pcg Signal. Signal Processing. 2022;198:108588. Doi:10.1016/J.Sigpro.2022.108588
[19] M. Kumar Et Al., “Real-Time Dsp For Electronic Stethoscope Systems,” Ijert, Vol. 3, No. 6, Pp. 456–459, 2015.
[20] H. Singh, “Noise Reduction In Digital Stethoscope Recordings Using Adaptive Filters,” Ieee Transactions On Biomedical Engineering, Vol. 67, No. 2, Pp. 278–287, 2020.
[21] M. A. Islam Et Al., “Cardiopulmonary Sound Enhancement With Dsp Techniques,” Biomedical Signal Processing, Vol. 49, 2019.
[22] A. D. Bose, “Acoustics And Speaker Design For Diagnostic Applications,” Ieee Instrumentation & Measurement Magazine, Vol. 20, No. 3, Pp. 24–30, 2017.
[23] Uneke Cj, Ogbonna A, Oyibo Pg, Ekuma U. Bacteriological Assessment Of Stethoscopes Used By Medical Students In Nigeria. World Health Popul. 2010;12(3):22–34. Doi:10.12927/Whp.2010.21734
[24] Cdc. Infection Control Guidance: Sars-Cov-2 (Covid-19). Centers For Disease Control And Prevention. 2020.
[25] Rutala Wa, Weber Dj. Disinfection, Sterilization, And Control Of Hospital Waste. In: Bennett Je, Dolin R, Blaser Mj (Eds). Mandell, Douglas, And Bennett’s Principles And Practice Of Infectious Diseases. 9th Ed. Philadelphia: Elsevier; 2020.
[26] S. Patel Et Al., “Comparison Of Traditional And Electronic Stethoscopes In Clinical Settings,” J. Clin. Med., Vol. 9, No. 5, 2020.
[27] T. B. Nguyen Et Al., “Multichannel Heart Sound Acquisition Using Speaker-Based Auscultation,” Sensors, Vol. 22, No. 7, 2022.
[28] Telehealth Technology Assessment Center, “Electronic Stethoscopes: Technology Overview,” [Online]. Available: Https://Telehealthtechnology.Org.
[29] M. E. Tavel, “Cardiac Auscultation: A Glorious Past—And It Does Have A Future!” Circulation, Vol. 113, No. 9, Pp. 1255–1259, 2006, Doi: 10.1161/Circulationaha.105.592899.
[30] A. Mishra And B. Sinha, “Portable Cardiac Monitoring With External Audio Feedback,” Biomed. Signal Process. Control, Vol. 78, P. 103937, Jan. 2023, Doi: 10.1016/J.Bspc.2022.103937.
[31] Audacity Team, “Audacity: Free Audio Editor And Recorder,” Version 3.3.3, 2023. [Online]. Available: Https://Www.Audacityteam.Org
[32] Gnu Octave, “Gnu Octave: High-Level Language For Numerical Computations,” 2023. [Online]. Available: Https://Www.Gnu.Org/Software/Octave/
[33] K. Schmidt, “Heart Sound Analysis Using Wavelets And Fft,” J. Biomed. Eng., Vol. 55, No. 3, Pp. 231–240, 2020, Doi: 10.1016/J.Jbiomech.2020.109632.
[34] H. Singh And M. Patel, “Noise Reduction In Digital Stethoscope Recordings Using Adaptive Filters,” Ieee Trans. Biomed. Eng., Vol. 67, No. 2, Pp. 278–287, Feb. 2020, Doi: 10.1109/Tbme.2019.2927086.
[35] M. Elsaadany, A. Abo-Zahhad, And A. Ahmed, "Development Of A Digital Stethoscope For Cardiac Murmurs," Ieee Access, Vol. 8, Pp. 123456–123467, 2020. [Online]. Available: Https://Doi.Org/10.1109/Access.2020.2999999
[36] H. B. Wahab, M. H. Habaebi, And H. H. Yousif, "Noise Reduction In Biomedical Signals: A Survey," Ieee Reviews In Biomedical Engineering, Vol. 14, Pp. 18–37, 2021. [Online]. Available: Https://Doi.Org/10.1109/Rbme.2020.3001234
[37] Y. Choi Et Al., "Heart Sound Signal Processing Techniques For Cardiovascular Diagnosis: A Review," Sensors, Vol. 21, No. 21, P. 7126, 2021. [Online]. Available: Https://Doi.Org/10.3390/S21217126
[38] M. E. Schmidt Et Al., "Filtering Lung And Heart Sounds: State-Of-The-Art And Future Directions," Biomedical Signal Processing And Control, Vol. 78, P. 103883, 2022. [Online]. Available: Https://Doi.Org/10.1016/J.Bspc.2022.103883
[39] K. J. Kwon And S. Y. Lee, "Efficient Fir Filter Design For Biomedical Acoustic Signals," Electronics, Vol. 11, No. 5, P. 850, 2022. [Online]. Available: Https://Doi.Org/10.3390/Electronics11050850
[40] A. Ali Et Al., "Frequency Analysis Of Heart Sounds For Cardiovascular Diagnosis," Ieee Access, Vol. 9, Pp. 145678–145690, 2021. [Online]. Available: Https://Doi.Org/10.1109/Access.2021.3111111
[41] N. D. Thanh Et Al., "Fast Fourier Transform-Based Analysis For Biomedical Acoustic Signals," Measurement, Vol. 177, P. 109330, 2021. [Online]. Available: Https://Doi.Org/10.1016/J.Measurement.2021.109330
[42] A. S. Pathan, A. K. Ray, And A. Shukla, "Time-Frequency Representation For Non-Stationary Biomedical Signals: Methods And Applications," Biomedical Signal Processing And Control, Vol. 69, P. 102907, 2021. [Online]. Available: Https://Doi.Org/10.1016/J.Bspc.2021.102907
[43] S. E. Schmidt And J. H. Pedersen, "Spectrogram-Based Heart And Lung Sound Analysis For Disease Detection," Computers In Biology And Medicine, Vol. 143, P. 105318, 2022. [Online]. Available: Https://Doi.Org/10.1016/J.Compbiomed.2022.105318
[44] P. T. Nguyen Et Al., "Rms-Based Evaluation Of Biomedical Signals For Wearable Device Validation," Ieee Sensors Journal, Vol. 21, No. 15, Pp. 17045–17056, 2021. [Online]. Available: Https://Doi.Org/10.1109/Jsen.2021.3088888
[45] M. R. Hassan Et Al., "Comparative Study Of Stethoscope Performance Using Rms And Peak Amplitude Metrics," Medical Engineering & Physics, Vol. 97, Pp. 49–57, 2022. [Online]. Available: Https://Doi.Org/10.1016/J.Medengphy.2021.12.002
[46] J. W. Lee Et Al., "Snr Improvement Techniques For Biomedical Acoustic Monitoring," Ieee Transactions On Biomedical Circuits And Systems, Vol. 15, No. 6, Pp. 1234–1245, 2021. [Online]. Available: Https://Doi.Org/10.1109/Tbcas.2021.3099999
[47] K. Zhang Et Al., "Evaluation Of Noise Reduction Algorithms For Auscultation Devices," Ieee Access, Vol. 10, Pp. 45678–45690, 2022. [Online]. Available: Https://Doi.Org/10.1109/Access.2022.3165432
[48] F. Al-Qaralleh Et Al., "Wiener Filtering Approach For Enhanced Biomedical Sound Acquisition," Ieee Access, Vol. 9, Pp. 159000–159012, 2021. [Online]. Available: Https://Doi.Org/10.1109/Access.2021.3133333
[49] R. W. Schafer And L. R. Rabiner, "The Theory And Application Of Wiener Filtering In Signal Processing," Ieee Signal Processing Magazine, Vol. 37, No. 4, Pp. 54–69, 2020. [Online]. Available: Https://Doi.Org/10.1109/Msp.2020.2987276
Copyright (c) 2025 Kusnanto Mukti Wibowo, Abdul Latif, Fani Susanto, Fatiatun Fatiatun, Norhidayah Che Ani (Author)

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlikel 4.0 International (CC BY-SA 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).





