What is Heart Murmur

Heart murmur is an extra sound that is caused by chaotic blood flow. The murmur can be heard as a “hum” or “whoosh” sound when blood flows through the heart.

The heart has four areas called chambers. Valves separate the upper and lower chambers from each other (tricuspid valve and mitral valve) and separate the lower chambers of the heart from pathways that lead away from the heart (aortic valve and pulmonary valve). Normally, the valves open to let blood flow through or out of your heart, and then they shut to keep the blood from flowing backward.

There are two types of heart murmurs:

• Innocent murmurs. Most people with this type of heart murmur do not have a heart problem. Many children have innocent heart murmurs. Your health care provider may suggest some basic testing to find out whether your murmur is an innocent murmur. If an innocent heart murmur is found, there is no need for further tests or treatment and no need to restrict activities or stop playing sports.
• Abnormal murmurs. These types of murmurs can occur in children and adults. Abnormal murmurs may be a sign of a more serious heart condition, such as a heart defect present at birth (congenital defect) or heart valve disease.

What are the causes?

This condition is caused by heart valves that are not working properly. In children, abnormal heart murmurs are typically caused by congenital defects. In adults, abnormal murmurs are usually from heart valve problems caused by disease, infection, or aging. Three types of heart valve defects can cause a murmur:

• Regurgitation. This is when blood leaks back through the valve in the wrong direction.
• Mitral valve prolapse. This is when the mitral valve of the heart has a loose flap and does not close tightly.
• Stenosis. This is when a valve does not open enough and blocks blood flow.

This condition may also be caused by:

• Pregnancy.
• Fever.
• Overactive thyroid gland.
• Anemia.
• Exercise.
• Rapid growth spurts (in children).

What are the signs or symptoms?

Innocent murmurs do not cause symptoms, and many people with abnormal murmurs may or may not have symptoms. If symptoms do develop, they may include:

• Shortness of breath.
• Blue coloring of the skin, especially on the fingertips.
• Chest pain.
• Palpitations, or feeling a fluttering or skipped heartbeat.
• Fainting.
• Persistent cough.
• Getting tired much faster than expected.
• Swelling in the abdomen, feet, or ankles.

How is this diagnosed?

This condition may be diagnosed during a routine physical or other exam. If your health care provider hears a murmur with a stethoscope, he or she will listen for:

• Where the murmur is located in your heart.
• How long the murmur lasts (duration).
• When the murmur is heard during the heartbeat.
• How loud the murmur is. This may help the health care provider figure out what is causing the murmur.

You may be referred to a heart specialist (cardiologist). You may also have other tests, including:

• Electrocardiogram (ECG or EKG). This test measures the electrical activity of your heart.
• Echocardiogram. This test uses high frequency sound waves to make pictures of your heart.
• MRI or chest X-ray.
• Cardiac catheterization. This test looks at blood flow through the heart.

For children and adults who have an abnormal heart murmur and want to stay active, it is important to complete testing, review test results, and receive recommendations from your health care provider. If heart disease is present, it may not be safe to play or be active.

How is this treated?

Heart murmurs themselves do not need treatment. In some cases, a heart murmur may go away on its own. If an underlying problem or disease is causing the murmur, you may need treatment. If treatment is needed, it will depend on the type and severity of the disease or heart problem causing the murmur. Treatment may include:

• Medicine.
• Surgery.
• Dietary and lifestyle changes.

Follow these instructions at home:

• Talk with your health care provider before participating in sports or other activities that require a lot of effort and energy (are strenuous).
• Learn as much as possible about your condition and any related diseases. Ask your health care provider if you may at risk for any medical emergencies.
• Talk with your health care provider about what symptoms you should look out for.
• It is up to you to get your test results. Ask your health care provider, or the department that is doing the test, when your results will be ready.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You feel light-headed.
• You are frequently short of breath.
• You feel more tired than usual.
• You are having a hard time keeping up with normal activities or fitness routines.
• You have swelling in your ankles or feet.
• You have chest pain.
• You notice that your heart often beats irregularly.
• You develop any new symptoms.

Get help right away if:

• You develop severe chest pain.
• You are having trouble breathing.
• You have fainting spells.
• Your symptoms suddenly get worse.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

• Normally, the heart valves open to let blood flow through or out of your heart, and then they shut to keep the blood from flowing backward.
• Heart murmur is caused by heart valves that are not working properly.
• You may need treatment if an underlying problem or disease is causing the heart murmur. Treatment may include medicine, surgery, or dietary and lifestyle changes.
• Talk with your health care provider before participating in sports or other activities that require a lot of effort and energy (are strenuous).
• Talk with your health care provider about what symptoms you should watch out for.