Korotkoff sounds

The Korotkoff sounds are like discovering a secret melody of the human body, a score played by the blood flow that can only be heard with the right instruments: a sphygmomanometer and a stethoscope, delicately placed on the brachial artery. It was Nikolai Korotkov, a Russian physician, who revealed these sounds to the world in 1905, like a conductor unveiling a new symphony at the Imperial Medical Academy of Saint Petersburg.

A Unique Symphony

Imagine perfect silence. Not a sound. That’s what you normally hear if you place a stethoscope on an artery without any issues. The blood flows quietly, without any disturbance, like a calm river. But as soon as you start inflating the cuff of the sphygmomanometer, you create tension, a sort of sound suspense. When the pressure in the cuff exceeds that of the heart, the blood can no longer circulate, and silence reigns supreme.

Then, as the cuff pressure decreases, the first act of the symphony begins. The first Korotkoff sound appears: a clear, powerful snap, indicating that the blood has managed to force its way through the compressed artery. It’s the birth of sound, the beginning of a series of notes that tell an invisible story.

The Five Acts of Korotkoff Sounds

Korotkoff discovered that this body symphony unfolds in five acts, each with its own sound color:

1. First act: the sharp snap. This sound marks the systolic pressure, the moment when the heart beats with enough force to push blood through the partially compressed artery. It’s like the kickoff of a concert.
2. Second act: the soft murmur. Between systolic and diastolic pressure, the sound becomes softer, a continuous murmur, almost soothing, following the wave of blood flow.
3. Third act: the intense sound. Here, you can perceive a brief increase in intensity, a louder, more pronounced sound, like a high note that briefly rings out before fading.
4. Fourth act: the muffled and soft sound. At this stage, you’re nearing the end of the symphony. The sound becomes more muffled, more subdued, almost nostalgic, signaling that the cuff pressure is approaching diastolic pressure.
5. Fifth act: the silence. Finally, calm returns. The cuff pressure now matches the diastolic pressure, and the blood flows once again in silence, smooth and harmonious.

The second and third acts do not have a major clinical role, but they add a fascinating sound texture to the whole, like subtle notes in a musical composition.

The Magic of Body Sounds

For a sound enthusiast, Korotkoff sounds are an incredible discovery, proof that our body is a true symphony in perpetual motion. Every heartbeat, every blood flow is a note in a melody that plays without interruption, an inner music that few have the chance to hear. And that’s the charm of Korotkoff sounds: they remind us that even in apparent silence, there’s always music playing, just beneath the surface.

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11/09/2024