What is a Heart Murmur? Symptoms, Causes, & Treatment

A heart murmur is simply an extra sound your heart makes between its regular beats. Think of it as a whooshing or swishing noise that your doctor can hear through a stethoscope. Most heart murmurs are completely harmless and don't require any treatment at all.

While the word "murmur" might sound concerning, it's important to know that many people live their entire lives with innocent heart murmurs without ever experiencing problems. However, some murmurs can signal underlying heart conditions that need attention.

What is a Heart Murmur?

A heart murmur occurs when blood flows through your heart in a way that creates turbulence, producing an extra sound. Your heart normally makes two distinct sounds as it beats, often described as "lub-dub." A murmur adds a third sound, like a gentle whoosh or swish.

Heart murmurs fall into two main categories: innocent (also called functional) and abnormal. Innocent murmurs are harmless and don't affect your heart's ability to pump blood effectively. Abnormal murmurs may indicate structural problems with your heart that need medical evaluation.

Many children have innocent heart murmurs that disappear as they grow older. Adults can also develop new murmurs due to changes in their heart or blood flow patterns throughout life.

What are the Symptoms of Heart Murmurs?

Most heart murmurs don't cause any symptoms at all. Innocent murmurs are typically discovered during routine check-ups when your doctor listens to your heart with a stethoscope.

However, if your heart murmur is related to an underlying heart condition, you might experience some symptoms. Here are signs that warrant attention:

• Shortness of breath, especially during physical activity or when lying flat
• Chest pain or discomfort that feels like pressure or tightness
• Fatigue that seems unusual or gets worse over time
• Dizziness or feeling lightheaded, particularly when standing up
• Rapid or irregular heartbeat that you can feel
• Swelling in your legs, ankles, or feet
• Fainting spells or feeling like you might pass out

If you experience any of these symptoms along with a known heart murmur, it's wise to contact your healthcare provider. They can help determine whether your symptoms are related to your murmur or something else entirely.

What are the Types of Heart Murmurs?

Heart murmurs are classified into two main types based on whether they indicate a problem with your heart's structure or function.

Innocent Heart Murmurs: These are harmless sounds that don't indicate any heart problems. They're extremely common in children and may come and go throughout life. Innocent murmurs often become more noticeable when your heart rate increases due to fever, exercise, or excitement.

Abnormal Heart Murmurs: These murmurs suggest there may be a structural problem with your heart. They can be present from birth (congenital) or develop later in life (acquired). Abnormal murmurs require further evaluation to determine the underlying cause.

Doctors also classify murmurs by their timing during your heartbeat, their loudness, and their location in your chest. This information helps them understand what might be causing the murmur and whether it needs treatment.

What Causes Heart Murmurs?

Heart murmurs develop when blood flow through your heart becomes turbulent rather than smooth. This turbulence can happen for many different reasons, ranging from completely normal variations to structural heart problems.

Let's explore the common causes of innocent heart murmurs first, which are completely normal variations:

• Physical activity or exercise that increases your heart rate
• Pregnancy, which increases blood volume and flow
• Fever, which makes your heart pump faster
• Hyperthyroidism, where your thyroid produces too much hormone
• Anemia, which means you have fewer red blood cells to carry oxygen
• Rapid growth periods in children and teenagers

Abnormal heart murmurs can result from structural problems with your heart that you're born with or that develop over time. Here are the main causes:

• Heart valve problems, such as valves that don't open or close properly
• Holes in the heart's walls (septal defects) present from birth
• Thickened heart muscle (hypertrophic cardiomyopathy)
• Heart infections that damage the heart valves
• Rheumatic fever, which can scar heart valves
• High blood pressure that makes the heart work harder over time

In rare cases, abnormal murmurs can indicate more complex congenital heart conditions or acquired heart diseases. Your doctor can help determine which category your murmur falls into through careful evaluation.

When to See a Doctor for Heart Murmurs?

You should see a doctor if you experience any symptoms that concern you, especially if they seem related to your heart. Don't wait if you're having chest pain, severe shortness of breath, or fainting spells.

If you have a known heart murmur, schedule an appointment with your healthcare provider if you notice new or worsening symptoms. Changes in how you feel could indicate that your murmur needs closer attention or that something else is developing.

For children with heart murmurs, regular check-ups are important to monitor whether the murmur changes over time. Most innocent murmurs in children don't require special treatment, but your pediatrician will want to keep track of them as your child grows.

Additionally, if you're planning to become pregnant and have a known heart murmur, it's wise to discuss this with your doctor beforehand. Pregnancy increases the workload on your heart, and some heart conditions require monitoring during pregnancy.

What are the Risk Factors for Heart Murmurs?

Several factors can increase your likelihood of developing a heart murmur, though many people with risk factors never develop murmurs at all.

Some risk factors are present from birth or related to your family history:

• Family history of heart defects or heart disease
• Genetic conditions that affect heart development
• Certain medications taken during pregnancy
• Maternal infections during pregnancy, such as rubella
• Premature birth or low birth weight

Other risk factors develop throughout life based on your health conditions and lifestyle:

• High blood pressure that isn't well controlled
• Previous heart infections or rheumatic fever
• Thyroid disorders, particularly hyperthyroidism
• Certain autoimmune conditions
• Age-related changes in heart valves
• History of heart attacks or other heart problems

Having risk factors doesn't mean you'll definitely develop a heart murmur, and many murmurs occur in people without any risk factors. The important thing is maintaining good overall heart health through regular check-ups and healthy lifestyle choices.

What are the Possible Complications of Heart Murmurs?

Innocent heart murmurs don't cause complications because they don't indicate any underlying heart problems. You can live a completely normal, active life with an innocent murmur.

However, abnormal heart murmurs that stem from structural heart problems can lead to complications if left untreated. The specific complications depend on what's causing your murmur:

• Heart failure, where your heart can't pump blood effectively
• Irregular heart rhythms (arrhythmias) that can affect blood flow
• Blood clots that can travel to other parts of your body
• Stroke, particularly if you have certain valve problems
• Heart infections (endocarditis) in people with certain heart conditions
• Sudden cardiac death in rare cases of severe structural problems

The good news is that most heart conditions causing abnormal murmurs can be effectively managed with proper medical care. Early detection and treatment significantly reduce the risk of complications.

Some rare complications can occur with specific congenital heart defects, such as Eisenmenger syndrome, where abnormal blood flow patterns develop over time. These complex conditions require specialized cardiac care from birth.

How Can Heart Murmurs be Prevented?

You can't prevent innocent heart murmurs because they're a normal variation in how blood flows through your heart. Many congenital heart defects that cause abnormal murmurs also can't be prevented since they develop during fetal development.

However, you can take steps to reduce your risk of acquired heart conditions that might lead to abnormal murmurs later in life:

• Maintain healthy blood pressure through diet, exercise, and medication if needed
• Eat a heart-healthy diet rich in fruits, vegetables, and whole grains
• Exercise regularly according to your doctor's recommendations
• Don't smoke, and avoid secondhand smoke exposure
• Limit alcohol consumption to moderate levels
• Manage diabetes, high cholesterol, and other chronic conditions
• Get prompt treatment for infections, especially strep throat

For pregnant women, taking prenatal vitamins, avoiding alcohol and smoking, and getting proper prenatal care can help support healthy heart development in their babies.

If you have certain heart conditions, your doctor might recommend antibiotics before dental procedures or surgeries to prevent heart infections. This is called antibiotic prophylaxis and is only needed for specific high-risk situations.

How are Heart Murmurs Diagnosed?

Heart murmurs are typically first detected when your doctor listens to your heart with a stethoscope during a routine examination. They can hear the extra sound between your normal heartbeats.

Your doctor will note several characteristics of your murmur, including when it occurs during your heartbeat, how loud it is, and where it's heard best on your chest. This information helps them determine whether your murmur is likely innocent or needs further investigation.

If your doctor suspects an abnormal murmur, they may recommend additional tests to get a clearer picture of your heart's structure and function:

• Echocardiogram, which uses sound waves to create moving pictures of your heart
• Electrocardiogram (ECG), which records your heart's electrical activity
• Chest X-ray to see the size and shape of your heart
• Cardiac catheterization for detailed images of your heart's blood vessels
• Exercise stress test to see how your heart responds to physical activity

Most people with heart murmurs only need an echocardiogram to confirm whether their murmur is innocent or abnormal. This test is completely painless and provides detailed information about your heart's structure and how well it's working.

In some cases, your doctor might refer you to a cardiologist, a heart specialist, for further evaluation. This doesn't necessarily mean there's a serious problem, but rather ensures you get the most expert assessment possible.

What is the Treatment for Heart Murmurs?

Innocent heart murmurs don't require any treatment because they don't indicate a heart problem. Your doctor will simply monitor your murmur during regular check-ups to ensure it remains harmless.

For abnormal heart murmurs, treatment depends entirely on the underlying heart condition causing the murmur. Your doctor will focus on treating the root cause rather than the murmur itself.

Common treatment approaches for conditions causing abnormal murmurs include:

• Medications to help your heart pump more effectively or control heart rhythm
• Blood thinners to prevent clots if you have certain valve problems
• Antibiotics to treat heart infections
• Surgery to repair or replace damaged heart valves
• Procedures to close holes in the heart's walls
• Lifestyle changes to support overall heart health

Many people with abnormal murmurs can be successfully treated with medications alone. Others might need surgical procedures, but modern heart surgery has excellent success rates and can dramatically improve quality of life.

In rare cases of complex congenital heart defects, treatment might involve multiple surgeries over time or specialized procedures performed by pediatric heart surgeons. These situations require care from specialized medical teams experienced in treating complex heart conditions.

How to Take Care of Yourself at Home with Heart Murmurs?

If you have an innocent heart murmur, you can live normally without any special precautions. Continue with your regular activities, exercise as you normally would, and maintain a healthy lifestyle.

For abnormal heart murmurs, your home care will depend on your specific heart condition. Here are general guidelines that apply to most people with heart murmurs:

• Take all prescribed medications exactly as directed by your doctor
• Monitor your symptoms and report any changes to your healthcare provider
• Maintain a heart-healthy diet low in sodium and saturated fats
• Stay physically active within the limits recommended by your doctor
• Get adequate sleep and manage stress effectively
• Avoid smoking and limit alcohol consumption
• Keep all follow-up appointments with your healthcare team

Pay attention to how you feel during daily activities. If you notice increased shortness of breath, chest pain, or unusual fatigue, contact your doctor promptly rather than waiting for your next scheduled appointment.

Some people with certain heart conditions need to take antibiotics before dental procedures or surgeries. If this applies to you, make sure all your healthcare providers know about your heart condition and antibiotic requirements.

How Should You Prepare for Your Doctor Appointment?

Before your appointment, write down any symptoms you've been experiencing, even if they seem unrelated to your heart. Include when they occur, how long they last, and what makes them better or worse.

Bring a complete list of all medications you're taking, including over-the-counter drugs, supplements, and herbal remedies. Some medications can affect your heart or interact with heart medications.

Prepare a list of questions you want to ask your doctor. Here are some important ones to consider:

• Is my heart murmur innocent or abnormal?
• Do I need any additional tests or monitoring?
• Are there any activities I should avoid?
• What symptoms should prompt me to call you?
• Do I need to see a heart specialist?
• Will my murmur affect my life expectancy or quality of life?

If you have a family history of heart problems, bring information about your relatives' heart conditions. This can help your doctor better understand your risk factors and determine the best approach for your care.

Consider bringing a trusted friend or family member to your appointment, especially if you're feeling anxious about your heart murmur. They can help you remember important information and provide emotional support.

What's the Key Takeaway About Heart Murmurs?

The most important thing to remember is that most heart murmurs are completely harmless. Many people live their entire lives with innocent heart murmurs without ever experiencing any problems or needing treatment.

Even if your heart murmur indicates an underlying heart condition, modern medicine offers excellent treatments that can help you maintain a good quality of life. The key is working with your healthcare team to monitor your condition and follow their recommendations.

Don't let anxiety about your heart murmur prevent you from living fully. With proper medical care and a heart-healthy lifestyle, most people with heart murmurs can participate in all the activities they enjoy.

Remember that having a heart murmur doesn't define you or limit your potential. Stay informed about your condition, maintain open communication with your healthcare providers, and focus on taking good care of your overall health.