What is a Heart Murmur?
As the name suggests, a heart murmur refers to irregular sounds in the heartbeat cycle. This condition causes the heart to make swishing or whooshing sounds as it beats. The sound results from irregular blood turbulence in the heart. Doctors usually use a stethoscope to listen to the heart for murmurs. A healthy heart makes consistent, two-part thumping sounds when the heart valves open and close, but a murmur interrupts the pattern.
Like other cardiac disorders, patients may have a heart murmur from birth or they may develop the symptom later in life. On its own, it may not be a cause for concern. However, it may signal a more serious underlying medical condition. A heart murmur is often the first sign that a patient has another condition that affects the heart valves.
Characteristics of Heart Murmurs
Innocent Heart Murmurs
With this type of heart murmur, patients have a healthy, normal-functioning heart. But blood flows through the heart faster than normal, making a different sound than a normal heartbeat. Innocent heart murmurs are also called functional or physiologic murmurs. They are common in infants and children, but they usually disappear by the time they reach adulthood. There is no underlying health condition.
Abnormal Heart Murmurs
Difficulty feeding (in children)
Blue lips or fingertips
Failure to thrive
Swelling in the legs, ankles, feet, liver, neck veins or stomach
Difficulty with exercise or physical activity
Shortness of breath
Measuring Heart Murmurs
Doctors use a stethoscope to examine heart murmurs by assessing the heart’s timing, duration, tonal quality and pitch. There are two main types: systolic and diastolic. In a systolic heart murmur, the swishing sound occurs between the first and second sound. On the other hand, diastolic murmurs happen after the second sound.
Doctors describe the timing as early systolic, mid-systolic or late systolic. Duration refers to how long the abnormal sounds occur between heartbeats. For instance, holosystolic murmurs occur throughout systole. Heart murmurs can also be described using pitch — low, medium or high.
There are various classifications to describe the shape of a heart murmur, including crescendo and decrescendo. The former refers to a heart murmur that increases in intensity, while the latter describes one that decreases in intensity.
Causes of Heart Murmurs
Innocent Heart Murmurs
Innocent heart murmurs occur when blood moves much more rapidly through the heart than normally. They occur without any underlying medical condition. Innocent murmurs may be caused by:
Intense physical activity
Innocent heart murmurs may disappear over time or they may last an entire lifetime without causing any adverse health effects. However, abnormal heart murmurs are associated with another condition.
Congenital Heart Defects
One common cause of heart murmurs in babies and children is congenital heart defects or problems with the structure of the heart. Congenital defects are present at birth.
In a septal defect, the patient has a hole between the right and left sides of the heart. The severity depends on their size and location. It causes abnormalities in blood flow between the heart chambers and heart vessels, causing irregular sounds in heartbeat.
Patent Ductus Arteriosus
Before birth, a fetus’ heart has a channel called a ductus arteriosus. The channel links the pulmonary artery and the aorta, which enables blood to bypass the lungs because the fetus does not breathe yet. However, the channel usually closes after birth and the infant starts breathing on its own. In some cases, the ductus arteriosus does not close and continues to function after birth, causing abnormal blood flow.
Heart Valve Abnormalities
Even though these abnormalities are present at birth, they may not be discovered until later in life. An example of a congenital heart valve abnormality is aortic valve stenosis, a condition that causes constricted valves that do not let enough blood through them. In other cases, the heart valves may not close correctly and then leak blood. This condition is called regurgitation.
Aortic Valve Calcification
Risk Factors for Heart Murmurs
Family History of Cardiac Disorders
According to research, the likelihood of a heart murmur increases if a patient’s relatives exhibit a history of cardiac disorders.
Underlying Health Conditions
Diagnosing Heart Murmurs
Physicians diagnose a heart murmur with a physical exam. The doctor uses a stethoscope to listen to the heartbeat, measuring the murmur’s volume, pitch, location, timing and length. This way, the physician can identify if the murmur is innocent or abnormal and if the patient has any other signs of heart problems. However, in some cases the patient may need additional tests to gather more information. Other diagnostic tests include an electrocardiogram, chest X-rays, echocardiogram and cardiac catheterization.
Treating & Preventing Heart Murmurs
Treatment for a heart murmur depends on the underlying cause. If the condition is innocent, the patient does not require treatment because it is not associated with any health condition. The patient has a normal heart structure and the symptom does not raise any concerns. It may even disappear on its own.
The murmur itself does not need treatment. However, if it signals another heart condition, the patient may require treatment for that, depending on the cause and any other symptoms. Treatment options include surgery, medication or a valve replacement procedure.
If medications do not solve the problem on their own, the patient may need a surgical procedure to address the cause of the murmur. A doctor may perform an annuloplasty, balloon valvuloplasty, structural support repair or valve leaflet repair.
The patient may also need a valve replacement procedure, such as open heart surgery or transcatheter aortic valve replacement (TAVR). An open heart surgery removes the damaged valve and replaces it with an artificial one. The artificial valve is either made of metal or tissue from a human donor. However, TAVR is a less invasive procedure. The doctor makes an incision in a vein in the leg or the chest to install the artificial valve.
Supplements for Heart Health
In addition to medical treatment, patients may also increase and maintain heart health with dietary supplements. They may provide a number of benefits to cardio health. However, they are not a medical treatment and may not be safe for all patients. Always consult a doctor before taking supplements.
Omega-3 Fatty Acids
Coenzyme Q10 (COQ10)
The Bottom Line
Heart murmurs are a symptom that causes a heart irregularity that makes swishing sounds between the regular two-part heartbeat. There are two types of heart murmurs: innocent and abnormal. The former occurs without any specific cause. They are common in infants and children and may disappear as the patient ages. On the other hand, the latter signals another problem in the heart. The murmur itself does not require treatment, but the underlying heart condition might.
There are various factors that may cause a heart murmur, including congenital heart defects, cardiac infections, high blood pressure, valve calcification or rheumatic fever. Some patients do not have any symptoms other than the murmur, but others may experience others. Common symptoms of a heart murmur include general weakness, fatigue, fainting, chest pain, shortness of breath and swelling in the body.
If the patient requires treatment, a doctor may prescribe medication or perform surgery or a valve replacement procedure. Dietary supplements may also help patients maintain a healthy cardiovascular system and avoid heart problems. However, they are not an effective medical cure on their own. But paired with other treatment options and a doctor’s permission, supplements may benefit a patient’s overall health.