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Heart Murmur: Causes, Symptoms, Diagnosis, Treatment, and Prevention

A heart murmur is a sound that is detected with a stethoscope when the blood flows abnormally through the heart valves. The heart murmur sounds like a whooshing or swishing sound, rather than the normal “lub-dub” of the heartbeat. It depends on the cause and severity of the abnormal blood flow whether a heart murmur is harmless (innocent) or worrisome (pathologic).

Causes of Heart Murmur

A heart murmur can be caused by various factors that affect the speed and direction of the blood flow through the heart. Some of these factors are:

• Innocent heart murmur: Usually caused by fever, anemia, pregnancy, exercise, growth spurts, or other temporary conditions that cause the blood flow to accelerate, this type of murmur is common in healthy people who do not have any heart problems. Usually, innocent heart murmurs do not cause complications and go away on their own.

• The congenital heart defect is caused by a structural problem with the heart or its valves and appears at birth. A hole in the wall between the heart chambers (atrial septal defect or ventricular septal defect), a narrowing of the valve opening (stenosis), or a leaky valve (regurgitation). As a result of congenital heart defects, blood flow and oxygen supply to the body can be affected, requiring surgery or other interventions.

• As a result of aging, infection, rheumatic fever, or other conditions, the heart valves may be damaged or degenerated, causing this type of murmur. A heart valve disease can lead to heart failure, stroke, or other complications if left untreated because it can cause thickening, calcification, scarring, or floppy valves.

• A heart murmur can also be caused by endocarditis (inflammation of the inner lining of the heart), cardiomyopathy (disease of the heart muscles), pericarditis (inflammation of the outer layer of the heart), aneurysms (ballooning of a blood vessel), or tumors (abnormal growths).

Symptoms of Heart Murmur

Many people with a heart murmur do not have any symptoms and are unaware of their condition. However, some people may experience signs and symptoms related to the underlying cause of the murmur, such as:

• Chest pain

• Shortness of breath

• Dizziness or fainting

• Fatigue or weakness

• Palpitations or irregular heartbeat

• Swelling in the legs, ankles, feet, abdomen, or neck veins

• Bluish color in the lips or nails

• Poor appetite or growth (in infants and children)

Diagnosis of Heart Murmur

In addition to listening to your heart sounds with a stethoscope during a physical examination, your doctor will also ask about your family history, medical history, and symptoms to detect a heart murmur. To confirm the diagnosis and determine the cause and severity of the murmur, the doctor may also perform some tests, such as:

• Electrocardiogram (ECG): This test records the electrical activity of the heart and shows any abnormal rhythms or signs of damage.

• Echocardiogram: This test uses sound waves to create an image of the heart and its valves and shows how well they function.

• Chest X-ray: This test uses radiation to produce an image of the chest and shows the size and shape of the heart and lungs.

• Cardiac catheterization: This test involves inserting a thin tube (catheter) into a blood vessel and guiding it to the heart. The catheter can measure the pressure and oxygen levels in different parts of the heart and inject a dye to visualize the blood flow.

• Other tests: Depending on your condition, you may also need other tests such as blood tests, stress tests, magnetic resonance imaging (MRI), or computed tomography (CT) scan.

Treatment of Heart Murmur

Treatment of a heart murmur depends on its cause and severity. Some people with innocent heart murmurs do not require treatment, while others with a worrisome murmur may require medication, surgery, or other procedures to correct the underlying problem. Treatment options include:

• Medication: Some medications can help reduce the symptoms and complications of a heart murmur by lowering blood pressure, preventing blood clots, controlling infection, reducing inflammation, or improving heart function.

• Surgery: Some types of surgery can repair or replace damaged or defective heart valves using artificial materials or biological tissues. Surgery can also close holes in the heart wall or remove tumors or aneurysms.

• Other procedures: Some other procedures that can treat a heart murmur are balloon valvuloplasty (inflating a balloon to widen a narrow valve opening), transcatheter aortic valve replacement (inserting a new valve through a catheter), or ablation (destroying abnormal heart tissue that causes irregular rhythms).

Prevention of Heart Murmur

While some heart murmurs cannot be prevented, especially those that are congenital or are caused by aging, there are some steps you can take to help prevent or reduce your risk of developing a heart murmur.

• Maintaining a healthy lifestyle by eating a balanced diet, exercising regularly, avoiding smoking, and limiting alcohol intake.

• Controlling chronic conditions such as high blood pressure, diabetes, or high cholesterol.

• Taking medications as prescribed and following up with your doctor regularly.

• Getting vaccinated against infections that can affect the heart, such as rheumatic fever or endocarditis.

• Practicing good hygiene and avoiding contact with people who have infections.

• Seeking medical attention promptly if you have any symptoms of a heart problem or infection.