HEART MURMUR

What is a heart murmur?

A normal heartbeat makes two sounds, "lub dub", which are the sounds of your heart valves closing. A heart murmur is an extra sound or noise heard during your heartbeat. It is sometimes described as a whooshing sound, made by blood circulating through the heart's chambers and valves or through blood vessels near the heart. Murmurs are graded from 1 to 6 depending on their intensity.

How does my doctor diagnose a heart murmur?

A heart murmur is detected by your doctor listening to your heart with a stethoscope. They are often discovered when a child is sick with a fever.

How serious is a heart murmur?

A heart murmur is not a disease. Most heart murmurs do not mean anything is wrong, but occasionally they are a sign of a heart problem.

Are there different kinds of heart murmurs?

Heart murmurs are classified as either normal or abnormal.

Normal heart murmurs are commonly referred to as "innocent", "functional", or "physiologic" because they are not caused by structural heart abnormalities. A person with an "innocent" heart murmur has a normal heart.

Abnormal heart murmurs are also called "pathologic" murmurs and are due to structural heart problems such as a hole in the heart, a narrowed valve (stenosis), or a leaky valve (regurgitation).

How does my doctor determine if a heart murmur is innocent?

Many innocent heart murmurs can be reliably diagnosed by asking specific questions and performing a physical examination. If any uncertainty remains, then referral to a pediatric cardiologist or additional testing may be requested.

How worried should I be?

Try to relax. Most healthy children with heart murmurs are diagnosed with innocent heart murmurs.

What testing is necessary?

Often testing is not necessary, but occasionally an electrical tracing (electrocardiogram) or an ultrasound (echocardiogram) are performed to help confirm the diagnosis. An electrocardiogram measures the electrical activity of the heart and an echocardiogram uses sound waves to make a picture of the heart. These are pain-free tests performed in a doctor's office or hospital.

How common are innocent heart murmurs?

They are very common in infants and children. It is estimated that at least half of all children will have an innocent heart murmur at some time during childhood or adolescence.

How long does a heart murmur last?

Most innocent heart murmurs disappear by adulthood, but some adults still have them. This is thought to be related to thickening of the chest wall with growth, making a heart murmur more difficult to hear. Innocent murmurs may also disappear and then reappear and they can become louder in some circumstances, such as during a fever or with anxiety.

What symptoms should I look for?

Innocent heart murmurs are harmless and do not cause any symptoms. They do not increase the risk of heart attacks or high blood pressure. Pathologic heart murmurs can be associated with symptoms, such as poor weight gain, difficulty feeding, rapid breathing, blue color changes, limited exercise ability, or fatigue.

What treatment is recommended?

There is no treatment for an innocent heart murmur because the child does not have a heart problem. Many pathologic murmurs also do not require treatment, but sometimes medication or open heart surgery may be necessary, which is directed at the underlying cause.

Are there any exercise limitations?

Children with innocent heart murmurs can participate in sports and be as active as any other child. However, some children with pathologic heart murmurs will have some exercise limitations.

What should I tell the dentist?

Children with innocent heart murmurs do not need any special precautions for dental work. On the other hand, children with pathologic murmurs may require antibiotics before dental work to prevent an infection from developing in the heart (endocarditis).