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Heart Murmur

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What Is a Heart Murmur?

A heart murmur is an extra or unusual sound heard during your heartbeat. Murmurs range from very faint to very loud and sometimes sound like a whooshing or swishing noise. Normal heartbeat sounds--"lub-DUPP" or "lub-DUB"--are the sounds of valves closing as blood moves through the heart.

A heart murmur is not a disease; it is a sound that the doctor hears with the stethoscope. It may be normal for your child, or it could be a sign that something may be wrong. Most heart murmurs are harmless. Some are a sign of a heart problem, especially if other signs or symptoms of a heart problem are present.

Types of Murmurs

Innocent (harmless) murmurs. A person with an innocent murmur has a normal heart and usually has no other symptoms or signs of a heart problem. Innocent murmurs are common in healthy children.

Abnormal murmurs. A person with an abnormal murmur usually has other signs or symptoms of a heart problem. Most abnormal murmurs in children are due to congenital heart disease--heart defects present at birth. In adults, abnormal murmurs are most often due to heart valve problems caused by infection, disease, or aging.

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Innocent Heart Murmurs

Innocent murmurs are heard when blood moves noisily through a normal heart. Sometimes these murmurs occur when:

  • Blood is flowing faster than usual through the heart and blood vessels attached to the heart
  • There is an increased amount of blood flowing through the heart.

Illnesses or conditions that can cause blood to flow faster than usual through the heart include:

  • Fever
  • Anemia
  • Too much thyroid hormone in the body (hyperthyroidism).

Many, if not most, children will have a heart murmur heard by their doctor at some time in their lives. After childhood, the most common cause of an increased amount of blood flowing through the heart is pregnancy. Most murmurs found in pregnant women are innocent. They are due to the extra blood women's bodies make while they are pregnant.

Innocent murmurs are sometimes due to changes to the heart resulting from heart surgery or from aging.

Abnormal Heart Murmurs

The most common cause of abnormal murmurs is congenital heart disease. Congenital heart disease occurs when the heart, heart valves, or blood vessels attached to the heart do not develop normally before a baby is born. Some babies are born with a combination of heart defects. Common defects that cause murmurs include:

  • Congenital septal defects, which are holes in the wall (septum) that separates the right and left sides of the heart. They account for more than half of abnormal murmurs in children.

  • Congenital valve defects, which include narrow valves that do not allow enough blood to flow through them and leaking valves that do not close properly.

Infections and other conditions that damage heart valves or other structures of the heart also may cause murmurs. These include:

  • Rheumatic fever, a serious illness that can develop after a person has an untreated or incompletely treated infection caused by the bacteria that cause "strep" throat or scarlet fever. Rheumatic fever can lead to permanent damage to the heart. If your doctor diagnoses strep throat, be sure your child takes all of the antibiotics prescribed, even if he or she feels better before the antibiotics run out.

  • Endocarditis, an inflammation of the inner lining of the heart and valves that is usually caused by a bacterial infection. Endocarditis is a serious disease that can lead to permanent heart damage and other complications. Endocarditis usually occurs in an abnormal heart.

  • Calcification (hardening and thickening) of valves as a result of aging. The hardened and thickened heart valves do not work as they should.

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What Are the Signs and Symptoms of Heart Murmurs?

Most people with a heart murmur do not have any other signs and symptoms of a heart problem. The murmur is usually innocent (harmless).

Some people with a heart murmur also have signs and symptoms of a heart problem. The signs and symptoms may include:

  • Blue coloring of the skin, especially on the fingertips and inside the mouth
  • Poor eating and failure to grow normally (in infants)
  • Fast breathing
  • Excessive sweating
  • Chest pain
  • Dizziness
  • Shortness of breath
  • Fainting
  • Fatigue (feeling very tired).

The signs and symptoms depend on the cause and the severity of the problem causing the murmur.

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How are Heart Murmurs Treated?

Innocent Murmurs

Healthy children with innocent murmurs do not need treatment because they have a normal heart. If your child has an innocent murmur, alert your pediatrician during regular checkups. Pregnant women with innocent murmurs due to increased blood volume also do not need treatment.

If you have an innocent murmur due to an illness or condition such as anemia, hyperthyroidism, or fever, the murmur will go away once the illness or condition is treated.

Abnormal Murmurs

The treatment for heart problems that cause abnormal murmurs varies depending on the specific heart problem.

The treatment of congenital heart disease is based on the type and severity of the heart defect or defects causing the murmur. Treatment may include medications or surgery. Children with congenital heart disease are treated by doctors who specialize in treating children's heart problems (pediatric cardiologists).

The treatment of heart problems caused by infection or disease depends on the type and severity of the damage to the heart and may include medications or surgery.

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Heart Murmur