About Heart Murmurs

Overview

A heart murmur is an extra sound that can be heard when blood flows through the heart. It is different from the normal sounds made by the heart during each heartbeat. The sound of a heart murmur can vary and may be described as whooshing, rasping, humming, or swishing. Heart murmurs can occur in both children and adults. There are two types of heart murmurs: innocent and abnormal. Innocent heart murmurs are harmless and often occur in babies, young people, and adults. They are usually louder when a person is excited or has a fever or a cold. Abnormal heart murmurs may be caused by congenital heart disease or other structural problems within the heart. Most heart murmurs are harmless, but they can sometimes indicate an underlying heart condition that requires further evaluation.

Causes and Risk Factors

Causes of heart murmurs include:

• Primary valvular abnormalities (such as degeneration, calcification, or infection of the valves)
• Secondary valve dysfunction (related to cardiomyopathy or pulmonary hypertension)
• Congenital heart defects (like valvular dysplasia, stenosis, septal defects, and patent ductus arteriosus)
• Scar tissue from a heart attack
• Heart disease
• High blood pressure

Non-modifiable risk factors of heart murmurs are factors that cannot be changed. These include:

• Congenital heart abnormalities present from birth
• Atypical connections in the heart and blood vessels

Modifiable risk factors of heart murmurs are factors that can be influenced or changed. These include:

• High fever
• Anemia
• Hyperactive thyroid gland
• Pregnancy

It's important to note that innocent or physiologic murmurs are due to benign causes like fever, excitement or stress, pregnancy, or anemia. These innocent murmurs usually resolve on their own. Abnormal murmurs typically require treatment. Remember to consult with your healthcare professional for personalized advice.

Symptoms

The most common early symptoms of heart murmurs may not be noticeable, especially in children. However, if the heart murmur is abnormal or associated with an underlying heart problem, other symptoms may occur. Here are the most common symptoms that may occur with the progression or higher severity of heart murmurs:

• Shortness of breath
• Light-headedness
• Episodes of rapid heartbeat
• Chest pain
• Decreased tolerance for physical exertion
• Symptoms of heart failure (in later stages)

It's important to note that not all heart murmurs cause symptoms, and innocent heart murmurs usually resolve on their own without any treatment. If you or your child experiences any concerning symptoms, it's best to consult with a healthcare professional for a proper evaluation and diagnosis.

Diagnosis

To diagnose heart murmurs, doctors commonly perform the following examinations, tests, and procedures:

• Physical examination: Doctors listen to the heart using a stethoscope and check for abnormal breathing patterns and changes in skin color.
• Chest X-ray: This test provides information about the size and shape of the heart and assesses the blood vessels that deliver blood to and from the lungs.
• Electrocardiogram (EKG): This test measures the electrical activity of the heart and can detect any damaged heart tissue.
• Echocardiogram: This test uses sound waves to assess the structure and function of the heart, including the movement of heart muscles.

To determine the stage or severity of heart murmurs, additional examinations, tests, and procedures may include:

• Cardiac magnetic resonance imaging (MRI): This imaging test allows doctors to view the heart as it pumps blood.
• Blood pressure measurement: Doctors measure blood pressure to assess heart function.
• Heart rate measurement: Doctors check pulse rate as part of evaluating heart health.
• Oxygen saturation level measurement: This test determines the amount of oxygen in the blood.
• Grading system: Doctors assign a grade or score to each heart murmur based on its intensity during different phases of the heartbeat.

Remember, specific examinations, tests, and procedures may vary depending on individual circumstances. It's important to consult with your healthcare professional for personalized advice.

Treatment Options

The goals of treatment for heart murmurs are to address the underlying condition causing the murmur, improve blood flow across the heart valves, and relieve any associated symptoms. Here are some treatment options that may be recommended:

Medication:

• ACE inhibitors: These medications help reduce blood pressure, improving blood flow across the valve.
• Antiarrhythmic medications: These drugs help regulate heart rhythm if abnormal rhythms are present.
• Antibiotics: Used to treat endocarditis, a bacterial infection that can cause heart murmurs.

Therapeutic procedures:

• Valve repair or replacement surgery: For severe cases, surgery may be necessary to correct a tight or leaky heart valve.
• Surgical correction of congenital heart defects: Depending on the severity of the defect, surgical intervention may be required.

Health behavior changes:

• Lifestyle modifications: Adopting a healthy lifestyle, including regular exercise, a balanced diet, and quitting smoking, can help manage underlying heart conditions and improve overall cardiovascular health.

It's important to note that the specific treatment plan will depend on the individual's condition and needs. Consulting with a healthcare professional is crucial for personalized advice and guidance. Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.