Masking of Korotkoff sounds used in blood pressure measurement through auscultation.

This article focuses on analyzing the psychoacoustic masking effects of electronic background noise on Korotkoff sounds (KSs) during manual blood pressure (BP) measurement by auscultation, which remains the gold standard for BP assessment. Using an electronic stethoscope, the study compares human observer perception of KS audibility with computational signal-to-noise ratio (SNR) analyses based on frequency-band energy comparisons between KSs and adjacent masking noise segments. Results confirm that KSs have low-frequency content without distinct spectral features separating them from noise artifacts, and that the difference limen (DL)—the minimum SNR for KS audibility—is approximately 5 to 10 dB, explaining the greater difficulty in accurately determining diastolic BP compared to systolic BP. The findings highlight the potential of psychoacoustic approaches to improve automated auscultation BP measurement by quantifying the perceptual thresholds involved in KS detection.