Egophony: Physical Exam
- A change in timbre (E to A,) but not pitch or volume
- Timbre is the "pronunciation" of a sound
- Accumulation of fluid or fibrosis in lung tissue enhances the transmission of high-frequency sounds while filtering out lower-frequency sounds leading to the high-pitched nasal/bleating sound characteristic of egophony
- Instruct the patient to say the word "bee" every time you touch them with your stethoscope
- Auscultate over the patient's chest with the diaphragm of a stethoscope
- If you find a place over the patient's chest that sounds like an "a" (as in "ate"), remove your earpieces to be sure the patient is saying "e"
- Return your stethoscope to your ears to verify you are hearing "a"
- Positive: Egophony is heard indicating some consolidation of lung tissue
- Negative: No egophony is heard indicating normal lung tissue is present
- False-positive: Occurs in the presence of fibrotic lung parenchyma
- The "a" sound heard in egophony has a nasal bleating quality, like the bleating of a goat
- Egophony displays the extent of consolidation but not the
- Use of the bell instead of the diaphragm during auscultation may hide the sounds of egophony
- Bickley LS et al. Bates' Guide to Physical Examination and History Taking. 11th ed. Philadelphia, PA: Lippincott Williams & Wilkins. 2013;314.
JM. Sapira's Art and Science of Bedside Diagnosis. 4th ed.
Philadelphia, PA: Lippincott Williams & Wilkins. 2010;299-301.
- Sapira JD. About Egophony. Chest. 1995;108(3):865-7.