A heart murmur is an extra sound heard during a heartbeat. The sound is usually caused by turbulent blood flow through the heart’s chambers or valves. It is important to note that the presence of a murmur doesn’t always mean your heart isn’t functioning normally and some murmurs may be harmless. In fact, many people have “innocent” or benign murmurs, which are of no medical consequences. However, some murmurs warrant further evaluation as they may indicate a more serious underlying cause.
Heart murmurs are classified by their location within the heart and their timing in relation to the heartbeat cycle. There are four main types of heart murmurs that can be detected on a physical exam:
- Systolic whistles
- Diastolic squeaks
- Pansystolic rumble
- Mid-diastolic rumble
It’s important for you to understand how each type feels so that you can better understand what your doctor is telling you about your murmur and what treatment options make sense for you.
What is a Heart Murmur?
A heart murmur is an abnormal sound heard between heartbeats that is caused by turbulent blood flow in the heart. It is usually a harmless but sometimes can be indicative of an underlying heart condition. People who experience this condition may feel a fluttering or racing of the heart, as well as other symptoms.
It is important to discuss any symptoms with your doctor to determine if a heart murmur is present.
Types of Heart Murmurs
Heart murmurs are extra or unusual sounds heard in the heart as it beats. Murmurs are usually harmless and may indicate a normal variation of blood flow. There are several types of heart murmurs, which vary depending on the cause and can be classified according to severity and location:
- Innocent or Physiologic Murmurs: These murmurs occur due to normal flow variations that often occur during physical activity, such as exercise. They are considered the most common type of murmur.
- PATHOLOGIC MURMURS: These types can indicate an underlying disease process like a heart valve disorder, an infection, or a hole in the heart muscle between the left and right ventricle (Ventricular septal defect, or VSD). Pathologic murmurs have irregular rhythms that may wax and wane with signs of illness like fever. Of all pathologic murmurs, stenotic murmurs–caused by blocked valves–are among the most common. Patients may also experience Systolic ejection murmur, caused by abnormally rapid blood flow through an area with a narrowed opening (stenosis).
- Abnormal cardiac sounds: This type is often heard after extended periods of intense exercise when there is intense turbulence in normal blood flow patterns due to increased pressure on vessels walls from increased cardiac output produced during exertion. So-called extra cardiac sounds like S3 and S4 can also be heard in these instances due to vibration and turbulent air movement associated with rapid filling of ventricles after contraction – conditions known as diastolic heart failure.
Causes of Heart Murmurs
Heart murmurs are usually caused by abnormalities of the heart valve, such as:
- A leaky or incompetent valve, where blood leaks back into the chambers instead of being pumped forward.
- A narrow valve due to an obstruction in the opening that can cause turbulence when the blood flows through it.
- Stenosis, which is when a valve becomes too tight and stiff and cannot open as wide as normal. This can cause turbulence when blood flows through it.
- Regurgitation, which is an abnormal backward flow of blood through one of the heart valves.
In some cases, murmurs can also be caused by congenital heart defects that are present at birth or acquired diseases, including rheumatic fever and other illnesses that can damage heart tissue. Murmurs can also be caused by infections, inflammation around the heart (pericarditis), or other conditions like mitral valve prolapse (MVP) and anemia (low red blood cells). Pregnancy may also make murmurs more noticeable due to increased amount of circulating blood volume.
Symptoms of Heart Murmur
Heart murmur is a condition where a person hears a swishing sound when their heart is beating. This sound is caused by the turbulence in the heart’s valves and it is the result of a defect in the heart’s structure. While some heart murmurs are harmless, others can cause serious problems and it is important to be aware of the symptoms.
In this section, we will take a closer look at the symptoms of heart murmurs:
People with a heart murmur typically appear outwardly healthy, and the condition is usually detected by a doctor during a physical exam. In certain cases, however, physical symptoms may be present. Common signs of heart murmur include:
- High blood pressure
- Shortness of breath with exertion or activity
- Swelling in the leg and feet (edema)
- Palpitations (rapid or skipped beats)
- Lightheadedness or near fainting episodes
- Rapid pulse rate
As well as physical symptoms, individuals with a heart murmur may also experience psychological symptoms. These include stress and anxiety, due to worrying about the health implications of their condition, or feeling embarrassed by their physical symptoms. Other psychological symptoms of a heart murmurs include difficulty concentrating, reduced confidence or self-esteem and sleep disturbances.
To cope with these psychological symptoms people can benefit from speaking to a mental health professional who may be able to help them manage their stress and anxiety levels. Relaxation techniques such as deep breathing and mindfulness also help provide a sense of calm and relaxation which can be beneficial when trying to manage feelings of worry or panic. Regular exercise can help increase energy levels, reduce strain on the heart muscle, as well as helping an individual feel better psychologically in general.
Diagnosis and Treatment
A heart murmur is an abnormal sound heard during a heartbeat. It is caused when the blood flow in the heart is turbulent and irregular. Diagnosis of a heart murmur usually involves a physical exam and listening to the heart with a stethoscope. Depending on severity, additional tests such as X-rays, electrocardiograms, and echocardiograms may be ordered. Treatment depends on the underlying cause, but may include:
- Lifestyle changes
When a doctor detects a heart murmur, they will order tests to diagnose the exact cause. Common tests used to assess heart murmurs are echocardiograms, electrocardiograms (ECG or EKG), chest X-rays and cardiac MRI.
These tests provide detailed information about the structure of your heart, how it is functioning and can reveal any underlying conditions that may be causing the murmur.
- Echocardiogram: A test using sound waves to check for abnormalities of your heart structure. It can determine if there are leaky valves or fluid build-up (essential for diagnosing congestive heart failure) and identify any arrhythmias present.
- Electrocardiogram (ECG): A diagnostic test which records the electrical activity of your heart over time to detect arrhythmias or other abnormal rhythms in the transmission of electrical impulses to the ventricles.
- Chest X Ray: An imaging test that uses X-ray beams to produce pictures of your chest area (including lungs and spine). This test is often used in conjunction with an ECG or echocardiogram to get an overall view of how the structures within your chest are working together.
- Cardiac MRI: An imaging technique that uses scans to produce detailed images of your heart’s structure and function. It is often used in tandem with other diagnostic tests such as echocardiograms and CT scans.
Once a diagnosis is obtained, treatment options depend on what type of murmur you have; they range from lifestyle changes such as changes in diet or exercise routines, prescription medications, interventional treatments such as ballooning/stenting procedures when necessary or possible surgery and valve replacement therapy.
Depending on the type and severity of the heart murmur, treatment options may include lifestyle changes and medications. Lifestyle modifications such as regular exercise, a healthy diet, quitting smoking, and reducing stress can help manage some of the symptoms associated with a heart murmur. Some medicines such as diuretics, beta-blockers or angiotensin-converting enzyme (ACE) inhibitors can be used to treat specific types of murmurs. Surgery may be an option in more serious cases when damage to the valves of the heart is discovered during an evaluation.
In order to make a proper diagnosis and determine the best course of treatment for an individual, it is important for patients to have an accurate diagnosis from their healthcare provider. During a medical evaluation, doctors will likely listen to your lungs and heart while you’re lying down and while standing up in order to determine causes which could lead to a misdiagnosis if not properly examined by qualified medical professionals. Careful observation over time may help distinguish between complex causes which require additional testing and therapies not mentioned here. With proper care prescribed according to individual needs, living with a heart murmur does not have to be difficult or life-altering.
Ultimately, feeling a heart murmur is not something everyone will experience. It’s important to tell your doctor or health care provider about any signs or symptoms you are experiencing, as well as any family history of heart murmurs. Your doctor can diagnose and monitor heart murmurs through clinical exams and diagnostic testing, such as an echocardiogram or electrocardiogram (ECG).
Treatment for a heart murmur may include:
- Lifestyle changes
depending on the cause. Regular check-ups with your doctor can help ensure the best outcome for a diagnosis of a heart murmur.