Embedded Analysis Of Heart Sounds

Mr. Yadnesh Sanzgiry

Department Of Electronics & Telecommunication Goa College Of Engineering. Farmagudi, Ponda - Goa
ysanzgiry@gmail.com

Prof. Dr. R. B. Lohani

Head of Department Department Of Electronics & Telecommunication Goa College Of Engineering. Farmagudi, Ponda Goa
rblohani@gec.ac.in

Mr. Anil Raikar

Philips India Ltd. Bangalore - Karnataka
Anil.raikar@philips.com

Abstract The medical device for listening to internal sounds in human body which is known, in medical terms, as auscultation is called a Stethoscope. Now-a-days there are electronic gadgets available for amplifying the heart sounds known as electronic stethoscopes. One short-coming in these devices is that the doctor has to do the diagnosis after listening to the heart sounds. In this project, heart sounds are processed by a microcontroller to generate the cardiac parameters.

Development of computer hardware and digital signal processing have caused heart sounds to be recorded and analyzed. This analysis though happens in the back-end. Thus the heart sounds are recorded and at a later stage are processed over computers in softwares like MATLAB. Doctors dont get the result at the time of patient diagnosis. More over signal recorded by the electronic stethoscopes are susceptible to artifacts, lung sound (breathing noise) and environmental noise. In order to design effective diagnosis algorithm using vital signals, it is observed that the noise cancelation during signal acquisition is a primary and indispensable task. This project is an attempt to build an electronic device that not only captures heart sounds accurately, but, also processes them to generate vital cardiac parameters.

I.

INTRODUCTION

Cardiovascular diseases are the leading cause of death in developing countries. Being a disease tightly connected to aging, it is observed that its incidence is on the rising due to the extended life expectancy. Auscultation is a technique in which a stethoscope is used to listen to the sounds of a body. Especially it is important for listening to the sounds of heart, in which the structural defects of the heart are often reflected and physician can usually make use of them. When they listen to the heart sound (HS), the physicians are particularly interested in abnormal sounds, which may suggest the presence of cardiac pathology and also provide diagnostic information. It is very difficult for the physician to make a diagnosis straightly according to the auscultation information because of the complexity and variability of HS and the limitation of the traditional auscultation technique. Normal heart sounds have two major components called the first heart sound (S1) and the second heart sound (S2). If there is a problem with one of the heart valves, erroneous sounds can be heard in either systole or diastole phase. In severe cases, the other sounds can completely dominate and distort S1 or S2 and are indicators of valvular cardiac disorder. They make a heart sound different from normal and a trained physician can identify and associate a particular cardiac disorder. However performing auscultation is subjective to each individuals hearing.

II.

BASICS OF THE SYSTEM

Heart sound signals reflects the mechanical movement of the heart and cardiovascular system, which contains physiological and pathological information of every part of heart and interactions among them[4]. The frequency range of heart sound is 0.1~800Hz, while regular measuring range is about 20~600Hz[5] . The heart sound detection system should be able to apply to this range to ensure accuracy and reliability. A. Heart sound signals and its characteristics Heart sound is the signal transmitted through the chest wall and surrounding tissue that caused by the mechanical vibration in the cardiac cycle as a result of the systolic and diastolic of myocardial, open and close of gate valve, blood washed the ventricular wall and main artery[1]. Typical heart sound signals is shown in Fig1, generally the heart sound signals including the first heart sound (S1), the second heart sound (S2) and no

audible murmurs. In some cases, the third heart sound (S3) and fourth heart sound (S4) can also be detected.

processed by this circuit is shown in figure 5. Channel D shows the signal post filtering and channel C shows the signal post amplification.

Figure 1. Typical heart sound signals waveform

Fig 3 : Filter and Amplifier III.

THE PRINCIPLE OF HEART SOUND SENSOR

B. The structure of the measurement system There are two types of heart sound measurements, intracardiac heart sound measurement and extra-cardiac heart sound measurement. Intra-cardiac heart sound is the heart sound that measured by a micro-heart sound sensor installed at the end of cardiac catheters inserted into heart or inside some heart vessels. Extra-cardiac heart sound is the common heart sound, which measured from the outer surface of chest wall. The basic block of the heart sound detection and processing system is shown in figure2.

There are multiple types of sensors that can be used in the chest piece of an electronic stethoscope to convert body sounds into an electronic signal. Microphones and accelerometers are the common choice of sensor for sound recording. These sensors have a high-frequency response that is quite adequate for body sounds. Rather, it is the low-frequency region that might cause problems. The microphone is an air coupled sensor that measure pressure waves induced by chest-wall movements while accelerometers are contact sensors which directly measures chest-wall movements. For recording of body sounds, both kinds can be used. Both transducers are popular in sound recording [13]. However, accelerometers are typically more expensive than microphones, are often fragile, and may exhibit internal resonances. Thus, this concludes that the microphone is perfect for the application.

Figure 2. System Block Diagram

The sensing element converts the acoustic heart sound into an electrical entity (voltage). This signal is very weak generally milli-volts hence needs to be amplified. After amplification, the unwanted components are eliminated via active filters. The true component of the signal now is processed by the microcontroller to calculate the cardiac parameters as desired. The microcontroller has an internal memory for storing data temporarily as and when required apart from the boot code. A display is provided by means of a LCD. An interface is also provided to transfer the data onto a PC via an USB 2.0 port. Figure 3 shows the signal conditioning unit comprising the amplifier and filter. The circuit was simulated before being fabricated onto a PCB. A normal heart sound after being

The WM-034DHB microphone I used is omni-directional with -42dB sensitivity, >60dB SNR, and a 20-16kHz response range.

Figure 4 Electret condenser microphone (left) and piezoelectric accelerometer (right)[14]

Table 1 shows a comparison between a condenser micro-phone and a dynamic micro-phone.

much lower filter order than a corresponding FIR filter. Although IIR filters have nonlinear phase, data processing within Matlab software is commonly performed "offline," that is, the entire data sequence is available prior to filtering. This allows for a non-causal, zero-phase filtering approach, which eliminates the nonlinear phase distortion of an IIR filter.

Table 1: Comparison between Dynamic And Condenser Microphone [12]

IV.

FILTERS

The sensors used in often pick up background noise, therefore it is important to filter that signal and only reproduce the sounds of interest. There are two kinds of filters, analog and digital, that can be used in an electronic stethoscope to reduce the ambient noise and increase the intensity of the desired signal[9]. A. Analog Filters An analog filter uses analog electronic circuits made up from components such as op-amps, capacitors, and resistors to produce the required filtering effect. The disadvantage of the analog filter is that large number of components may be needed to implement a filter that has sufficient roll-off at the desired cutoff frequency. Also, the multiple analog components required can add noise to the signal. B. Digital Filters Digital filters, however, can be implemented without added noise. The two digital filter types, finite impulse response (FIR) and infinite impulse response (IIR) can be implemented using software. Digital filters with FIR filters have both advantages and disadvantages compared to IIR filters. FIR filters are always stable, while IIR filters may be unstable. However, the primary advantage of IIR filters over FIR filters is that they typically meet a given set of specifications with a

Fig 5 Normal heart sound after filtering and amplification

V.

AMPLIFICATION

U1a operates as a low-noise microphone preamp. Its gain is only about 3.9 because the high output impedance of the drain of the FET inside the electret microphone causes U1as effective input resistor to be about 12.2K. C2 has a fairly high value in order to pass very low frequency (about 20 to 30Hz) heartbeat sounds. U1b operates as a low-noise Sallen and Key, Butterworth lowpass-filter with a cutoff frequency of about 103Hz. R7 and R8 provide a gain of about 1.6 and allow the use of equal values for C3 and C4 but still producing a sharp Butterworth

response. The rolloff rate is 12dB/octave. C3 and C4 can be reduced to 4.7nF to increase the cutoff frequency to 1KHz to hear respiratory or mechanical (automobile engine) sounds. VI. CARDIAC PARAMETERS

The cardiac parameters that can be measured using the device are Cardiac Reserve, Heart rate variability and heart defects that can be detected include Pulmonary Stenosis, Aortic regurgitation, Aortic Stenosis and Mitral Stenosis.[9] Heart Rate Variability and Cardiac reserve involve two recordings of heart sound. One at rest and the second after a predefined exercise. These parameters are characterized by variation in amplitude and frequency of the heart sound of patient under test due to the exercise.

Figure 7 : Aortic Regurgitation

The heart defects as mentioned are generally characterized by heart sounds which are abnormal in nature. Either the first sound S1 or the second sound S2 are abnormal or murmurs infect the same signifying the heart defect. Figures 6 to Figure 9 signify the various heart defects which can be detected by the system.

Figure 6 Pulmonary stenosis after filteration and amplification

Figure 8: Aortic Stenosis

Simple 8 wire interface On board 3.3V regulator Rest and INT1 switches Internal ADC JTAG standard port Algorithms are written in embedded C Flash Magic and loaded onto the controller via Flash magic using the ISP point on the serial input for the controller. The user has the choice of deciding between cardiac parameters and heart defects. In case of cardiac parameters, as stated before, two readings are required and for heart defects one recording would suffice[15]. VIII. POWER SUPPLY Most portable systems have one battery, thus, the popularity of portable equipment results in increased single supply applications. Although it is advantageous to implement op amp circuits with balanced dual supplies, there are many practical applications where, for energy conservation or other reasons, single-supply operation is necessary or desirable. But single-supply operation has its drawbacks: It requires additional passive components in each stage and, improper execution of the design can lead to serious instability problems. The circuit in Figure 11 shows a single-supply biasing method. 9V is chosen since it is compatible with the microphone, op amp and power amplifier. This non-inverting, op-amp circuit uses a resistor divider with two biasing resistors, R5 and R6, to set the voltage on the non-inverting input equal to Vcc/2. R5 and R6 are equal values, selected with power consumption versus allowable noise in mind

Figure 9: Mitral Stenosis

VII.

MICRO CONTROLLER

The analog signal obtained is first and foremost to be digitized. The sample and hold circuit is to be characterized at the right frequency for good sampling. The digitized signal will then be processed to calculate cardiac parameters like heart rate variability and Cardiac Reserve.

Figure 11 Schematic Diagram of a Single Supply Power Circuit

Figure 10 Rapid LPC 2138microcontroller Board

[12]

The microcontroller used is LPC 2138 based on ARM 7 core. The features[10] of this board are as follows: DTR, RTS signals for reset and bootloader enter point Dual UART interface UART0 & UART1 UART0/Programmer selection switch on ISP Programmer

The values of R5 and R6 are chosen to be as low as feasible; the 47 k values chosen here are intended to conserve supply current. Attempts to use small resistor values in the voltage divider will increase power-supply current consumption, may overheat the resistors, and certainly is not a good design approach. To avoid substantial feedback through the power supply at low signal frequencies, a larger capacitor is needed to effectively

bypass the voltage divider at all frequencies within the circuits passband. Therefore the capacitance value of 1F for C3 is chosen. IX. CONCLUSION

[5] Zhao.Zhidong,Tang Xianghong,Zao Zhijin. Spectrum Analysis of Heart Sound Based on Hilbert-Huang Transform, Chinese Journal ofSensor and Actuators,2005.1;18(1)pp.18-22 [6] She Ranyon Roston, Electronic Stethoscope SIM University May 2009. [7] Haibin Wang, Jian Chen and Yuliang Hu, Heart Sound Measurement and Analysis 978-1-4244-4134-1/09/$25.00 2009 IEEE [8] S. A. Jawed, M. Gottardi, A. Baschirotto, 1-4244-1001-0/07/$25.00 c2007 IEEE. Conference on Complex Medical Engineering. [9] P. Carvalho, P. Gil, J. Henriques, M. Antunes and L. Eugnio, Low Complexity Algorithm for Heart Sound Segmentation using the Variance Fractal Dimension, in Proc. of Int. Sym. on Intelligent Signal Processing, Algarve, Portugal, Sep 3-7. 2005, pp. 937-942 [10] www.philips .com/datasheets [11] Developing Custom Signal Processing Algorithm with LabView FPGA and Compact RIO to Detect the Aortic Stenosis Disease B Al-Naami1, J Chebil1, B Trabsheh1, H Mgdob Hashemite University, Zarqa, Jordan 2University of Sussex, Brighton, UK [12] Piezotronics Microphone handbook [13] IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS. AND
FREQUENCY CONTROL. VOL. 38. NO. 3. MAY 1991

Heart sound signals of human is a biologic signal in a strong noise background. There are certain specific obvious characteristics, including weak signals, strong noise, narrow frequency, and more randomness, of heart sound signals that normal signal does not have. The detection is liable to the impact of various factors of the human. The accuracy and reliability of heart sound detection will directly influence the analysis and treatment of heart sound. The heart defects detected can be increased by implemented more algorithms on the microcontroller[14]. REFERENCES
[1] Zhou Jing,Yang Yongming,He Wei. A New Algorithm of Heart Sound Feature Extraction, Chinese Journal of Biomedical Engineering, 2005.6; 24(6):pp.685-689. [2] Li Yong,Gao Xiao rong,Guo Aiwen.Time-frequency Analysis of Heart Sounds based on Continuous Wavelet Transform,2001 3,41(3). pp.77-80. [3] Zhou Jing,Yang Yongming,He Wei. A New Algorithm of Heart Sound Feature Extraction, Chinese Journal of Biomedical Engineering, 2005.6; 24(6):pp.685-689 [4] LiuJun,Jin Chongying,Wang Weilian.Data Recall and Analysis System of Heart Soundsand ECG Signals Based on Labview. Electronic Measurement Technology,2006;29(8):46-48.

[14] MICROPHONE DESIGN AND SELECTION FOR DEEPSUBMERGENCE ENVIRONMENTS, AUSTIN J. BROUNS ADVANCED TECHNOLOGY CENTER, INC. [15] Heart Sound Measurement and Analysis System with Digital Stethoscope Haibin Wang, Jian Chen and Yuliang Hu [16] Design and Implementation of a Remote Embedded DSP Stethoscope with a Method for Judging Heart Murmur Ying-Wen Bai