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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.
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 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
Illnesses or conditions that can cause blood to flow faster
than usual through the heart include:
- 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.
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
- 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
- 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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Most people with a heart murmur do not have any other signs
and symptoms of a heart problem. The murmur is usually
Some people with a heart murmur also have signs and
symptoms of a heart problem. The signs and symptoms may
- 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
- Shortness of breath
- Fatigue (feeling very tired).
The signs and symptoms depend on the cause and the severity
of the problem causing the
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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.
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
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
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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