Heart Murmur

Overview and Facts about Heart Murmur

A heart murmur is a condition in which an additional sound is heard during the heartbeat cycle. It typically sounds like a “swishing” and can be heard using a stethoscope. This heart condition exists in about 40 to 45% of children and 10% of adults.

Although heart murmurs themselves are not a disease, they can indicate an underlying heart condition. There are three main categories of heart murmurs. The first, and most common, is known as an “innocent murmur” because it does not require treatment. An innocent murmur can occur when blood flows more rapidly than normal through the heart.

The other two types of heart murmurs can indicate a heart problem. A diastolic murmur occurs as the heart fills with blood, and a continuous murmur happens throughout the heartbeat.

Signs and Symptoms of Heart Murmur

With an innocent heart murmur, there are no signs and symptoms beyond the irregular sounds. However, if you experience any of the following, your heart murmur may be related to a more serious heart problem:

• Bluish skin, especially on the fingertips and lips
• Swelling or sudden weight gain
• Shortness of breath
• Chronic cough
• Enlarged neck veins
• Enlarged liver
• Lack of appetite
• Chest pain
• Dizziness or fainting

Causes and Risk Factors of Heart Murmur

Heart murmurs are caused by turbulent blood flow near the heart. They can be present from birth (congenital), or they can develop later in life. Health conditions that can cause heart murmurs or serve as risk factors include:

• Pregnancy
• Anemia
• High blood pressure
• Overactive thyroid
• Fever
• Valve conditions, such as mitral valve prolapse or aortic stenosis
• Family history of heart defects

Tests and Diagnosis of Heart Murmur

The first things a doctor will do to test for and diagnose a heart murmur are discuss your medical history, perform a physical exam and listen to your heart with a stethoscope. To determine the degree of abnormality, the doctor will consider the answers to the following questions:

• How loud is the murmur?
• Where in the heart does the murmur occur?
• What is the pitch of the murmur?
• Does physical activity or changing body position affect the sound of the murmur?

If the doctor suspects the heart murmur is abnormal, they might order additional tests to check for underlying heart conditions. These tests include:

• Chest X-ray
• Electrocardiogram, which uses electrical impulses to make the heart beat so the doctor can check for structural issues
• Echocardiogram, which uses ultrasound waves to create images of the heart so the doctor can check for structural issues
• Cardiac catheterization, which involves injecting dye into the veins or arteries through a catheter, so the doctor can check for blood flow issues

Treatment and Care for Heart Murmur

Innocent murmurs do not require treatment, and murmurs caused by other heart conditions generally go away once that heart condition is treated. Medications the doctor might prescribe based on the problem include:

• Anticoagulants, which prevent blood clots
• Diuretics, or water pills, which remove excess fluid from the body and treat high blood pressure
• ACE inhibitors, which lower blood pressure
• Statins, which help lower cholesterol
• Beta blockers, which lower heart rate and blood pressure

If the murmur stems from a structural issue in the valves, surgery can restore normal blood flow.