A heart murmur refers to an extra or unusual sound heard during a heartbeat, distinct from the typical “lubb-dupp” sounds. These sounds, often described as whooshing, swishing, or rasping, are caused by turbulent or rapid blood flow through the heart. A doctor can detect a heart murmur using a stethoscope during a routine examination. While some murmurs can indicate an underlying heart condition, many are common and do not signify a serious problem.
Innocent Versus Abnormal Heart Murmurs
Heart murmurs are broadly categorized into two types: innocent and abnormal. Innocent heart murmurs are harmless sounds. They are common in children and often disappear by adulthood. Innocent murmurs can also arise during periods of rapid growth, pregnancy, fever, strenuous exercise, or due to conditions like anemia or an overactive thyroid, all of which temporarily increase blood flow.
In contrast, abnormal heart murmurs suggest an underlying issue with the heart’s structure or function. A medical professional can distinguish between innocent and abnormal murmurs by evaluating characteristics such as the murmur’s intensity, pitch, quality, location, and timing within the heartbeat. While innocent murmurs typically do not cause any symptoms, abnormal murmurs often accompany other signs that warrant medical attention.
Symptoms Associated with Worrisome Murmurs
When a heart murmur is abnormal, it is often accompanied by specific symptoms that signal a potential heart problem. Shortness of breath, especially during activity or rest, is a common indicator of heart dysfunction. Chest pain may also occur, worsening with exertion. Dizziness or fainting spells without an apparent cause are also concerning symptoms.
Other symptoms include a persistent cough that does not resolve, or swelling in the legs, ankles, or feet. Unexplained or sudden weight gain can also be a sign of fluid retention related to heart issues. A bluish tint to the skin, especially on the lips or fingertips (cyanosis), indicates poor oxygen circulation. For infants, difficulty feeding or failure to gain weight and grow are significant symptoms that should prompt medical evaluation. These symptoms suggest the heart may not be pumping blood effectively.
Underlying Causes of Abnormal Heart Murmurs
Abnormal heart murmurs stem from various underlying heart conditions that disrupt normal blood flow. Valvular heart disease frequently causes murmurs, involving issues with the heart’s four valves. These problems include stenosis, where a valve narrows or stiffens, impeding blood flow, or regurgitation, where a valve does not close completely, causing blood to leak backward. Both conditions create turbulent blood flow, leading to a murmur.
Congenital heart defects are structural problems present at birth that cause murmurs, such as a hole in the heart’s walls (septal defects) or abnormal connections between blood vessels. Examples include atrial septal defect (ASD) or ventricular septal defect (VSD), which allow blood to flow abnormally between heart chambers. Infections like endocarditis (inflammation of the heart’s inner lining or valves) or inflammatory diseases like rheumatic fever (a complication of strep throat) can damage heart valves, resulting in abnormal murmurs. Less commonly, conditions such as severe anemia or an overactive thyroid (hyperthyroidism) can also lead to murmurs by increasing the speed of blood flow, even if the heart structure is normal.
When to Seek Medical Attention and What to Expect
If you or your child exhibit any of the symptoms associated with worrisome murmurs, consulting a doctor is advised. If a heart murmur is detected during a routine physical examination, further evaluation is recommended to determine its nature.
During a medical evaluation, the doctor will conduct a physical examination, carefully listening to the heart with a stethoscope to assess the murmur’s characteristics, such as its loudness, location, and timing. To gain a more detailed understanding of the heart’s structure and function, additional tests may be ordered. These can include an echocardiogram, an ultrasound of the heart providing images of the heart chambers and valves, or an electrocardiogram (ECG/EKG), which records the heart’s electrical activity. While many murmurs are harmless, medical assessment is important to rule out any underlying conditions.