When I evaluate patients in the emergency department and intensive care unit, I often have to reposition my stethoscope and listen again and again to appreciate a subtle finding. A murmur may point to a valve problem, wheezing to obstructive airway disease, and crackles to fluid overload or another lung process. Each finding adds context and helps shape my next question. This takes concentration when the room is crowded and alarms are going off.

We now have technology—at the bedside—to address these issues. Eko Health recently launched the CORE 300, a stethoscope combining traditional and digital listening with AI-assisted structural-murmur detection.

In this article, I’ll discuss the challenges of auscultation in busy clinical settings, how the Eko’s CORE 300 works, and how this technology will impact physicians, patients, and the health system. 

My physical exam always starts before I place a stethoscope on a patient. I’m looking at how they’re breathing (fast or slow), whether they can speak in complete sentences, and how comfortable they appear. Then I start gathering more detail, including what I hear over the heart and lungs.

Like I said, those details can be extremely subtle. In a crowded ED, a sound may be difficult to appreciate on the first listen. Sometimes I need to reposition, listen for longer, or come back to a specific area of the chest.

Auscultation also requires interpretation. A patient with shortness of breath and crackles might have fluid in the lungs, but I still need the history, vital signs, the rest of the exam, and potentially additional testing to understand what’s happening. A murmur may warrant closer attention, but the sound alone doesn’t tell me everything about a patient’s heart or determine the next step.

Now, as AI enters the exam room, it can serve as a key tool to give me another piece of information to consider.

The CORE 300 is a stethoscope with traditional and digital listening modes. A twist switches between traditional and digital listening. Traditional mode works without battery power. The digital mode adds amplified listening (key) and other features.

In digital mode, the CORE 300 offers up to 35x sound amplification and active noise cancellation (it can reduce background noise by up to 63%). There are three listening filters:

The device can display heart rate in cardiac mode and, when connected to the Eko App, record sounds for playback.

I think about these features in terms of the exam. The pulmonary filter is relevant when I’m listening to breath sounds, while the cardiac filter is intended for heart sounds. A recording gives a clinician like me another way to revisit a sound when, perhaps, writing the note. How helpful those functions are in a particular clinical encounter still depends on the patient, the environment, and how the clinician uses them.

The CORE 300 can also use Eko’s FDA-cleared AI to help detect structural murmurs—sounds associated with an abnormality of the heart, such as a valve problem. The feature requires the Eko App and an Eko+ membership. To receive an AI result during a cardiac exam, a clinician takes a recording using the stethoscope or the Eko App. The result can appear on the stethoscope’s display.

During a cardiac exam, the AI provides another piece of information I can consider alongside what I hear, the patient’s history, and the rest of the exam. It supports my clinical judgment. It doesn’t make a diagnosis.

Eko reports that its structural-murmur algorithm achieved 93% sensitivity and 91% specificity in a real-world dataset. Sensitivity describes how often the algorithm detected a structural murmur when one was present. Specificity describes how often it returned a negative result when no structural murmur was present.

I’ve used an Eko stethoscope since medical school (I know, impressive I haven’t lost it), so the idea of bringing digital information into auscultation is familiar to me.

When I evaluate a clinical tool, I’m interested in what it contributes to the decisions I’m already making. The CORE 300 brings several functions into a device clinicians use during the physical exam. That makes it relevant to my day-to-day work, but the value of each feature depends on how it performs when I need it.

For clinicians like me, the appeal is having more information available during an exam I’m already performing. In a noisy ED or ICU, amplification and noise cancellation may help me focus on the sounds I’m trying to appreciate.

The AI feature adds another, better, layer to my cardiac exam. If it flags a possible structural murmur, I can consider that result alongside what I hear and the patient’s history. It may prompt me to take a closer look or consider further evaluation with echocardiogram or cardiology referral. The result informs my clinical judgment. It doesn’t make a diagnosis—important to note.

Recording and playback also give clinicians a way to revisit sounds and help educate trainees. In medical school, I listened to murmur recordings repeatedly on YouTube to train my ear. Being able to listen again is valuable when learning to recognize a finding connected to a specific patient.

As for health systems, they must invest in technology with the hope that clinicians will use it. The CORE 300’s features are built around a physical exam clinicians already perform, giving leaders a practical starting point when considering how the device might fit directly into care workflows.

The next step is understanding how clinicians use the features in their own setting and what happens after a finding. Evidence on follow-up (e.g., echocardiogram orders, cardiology referrals) and patient outcomes would help leaders assess the broader impact.

In summary, auscultation remains an important part of the physical exam, even when the environment makes listening difficult. The CORE 300 adds digital listening and AI-assisted structural-murmur detection to a familiar clinical tool. The information may help inform an assessment, but its usefulness depends on the evidence, the workflow, and the clinician interpreting it in context.

About this post: This is a sponsored deep dive with Eko Health. The analysis and conclusions, however, are my own. As a reminder, I only partner with companies working on problems I’d write about anyway, and Eko Health’s focus on helping clinicians listen more effectively during the physical exam fits that bar. As always, my goal is to give you a transparent breakdown of what works, what still needs scrutiny, and why it matters for patients, physicians, and the health system. If you or your company would be interested in a partnership like this, click here.