What is a Heart Murmur?

A heart murmur is the sound of blood flowing through the heart. Heart sounds can occur when the blood is flowing through a valve with a problem. Else, a heart murmur can happen when you have a condition in which your heart starts to beat faster. This results in faster blood flow, which leads to swishing sounds. Your doctor can hear heart murmurs with the help of a stethoscope. Heart murmur sounds can indicate a heart problem, but a person with an average heart can have heart murmurs, too. Some people have heart sounds and murmurs since birth, while others develop them as they age.

Heart Murmur Symptoms

There are various heart murmur symptoms. You won't show any symptoms if you have normal, harmless heart sounds. But if you have abnormal heart sounds, you are likely to show symptoms such as the following:

You might suddenly gain weight, although you did nothing unusual.
You might notice neck veins that have enlarged and are prominent.
You might have fainting spells.
You might experience a constant chronic cough that refuses to heal.
Your skin might turn blue. It is visible on the lip area and your fingertips.
You might have trouble breathing properly.
You might have chest pain that can be intense.
You might have an enlarged liver.
You might be sweating profusely even when there is no exertion.
Children might experience growth problems and might not feel hungry.

It is important to remember that you might not show symptoms when you have abnormal heart murmurs, too. It is best to check with your doctor to ensure you don't have any underlying problems.

Heart Murmur Causes

Causes of an innocent heart murmur:

An innocent heart murmur is caused when blood flows faster than it usually does through the heart. Any of the following can cause an innocent heart murmur:

You might be suffering from anaemia, which means your body cannot get enough oxygen because there aren't enough healthy red blood cells to carry oxygen-rich blood.
You might have a fever.
You might be doing intense physical activity or exercising, due to which rapid blood flow is taking place through your heart.
You might be pregnant.
Children who are becoming adolescents and are growing fast tend to have innocent heart murmurs.
You might have hyperthyroidism.

Causes of an abnormal heart murmur:

Abnormal heart murmurs can be caused due to the following problems:

Children and babies who are born with abnormal heart valves have abnormal heart murmurs. These are usually found when they become adults and suffer from problems such as regurgitation, where the valves leak due to improper closing. Another problem is stenosis, in which insufficient blood flows through the valves.

Abnormal heart murmurs can occur due to cardiac shunts or septal defects, which are holes in the heart. These usually affect infants and children. Their severity depends on where the holes are and what size they are. Holes in the heart can lead to abnormal heart murmurs when the blood flows abnormally between the blood vessels.

Rheumatic fever can lead to abnormal heart murmurs. Rheumatic fever is a serious condition that should be treated promptly. Although rheumatic fever is now rare, it can directly affect the heart valves, leading to abnormal blood flow. It causes abnormal heart murmurs.

Adults who have mitral valve prolapse can have abnormal heart murmurs. It is a problem where the mitral valve cannot close properly due to a section of the valve ballooning out. It can cause abnormal heart murmurs due to the backward flow of the blood through the valve, which can be serious.

Endocarditis can cause abnormal heart murmurs. It occurs when there's an infection in your heart's lining. This infection can be due to bacteria present in any part of your body that settles in your heart. If endocarditis isn't treated, it can damage the heart valves, leading to abnormal heart murmurs.

Valve calcification is another leading cause of abnormal heart murmurs. This condition develops when the aortic valve has calcium deposits on it. This leads to a problem at the aortic valve opening, which becomes narrow, making it difficult for the blood to flow.

Types of Heart Murmurs

There are two types of heart murmurs - innocent heart murmurs and abnormal heart murmurs. Innocent heart murmurs are normal, meaning the person with them has a healthy heart. It is more common in infants and children. Innocent heart murmurs are normal types of heart sounds. An abnormal heart murmur produces a fast heartbeat sound effect that is not normal. An abnormal heart murmur indicates that you might have an underlying problem, such as another heart problem

Are You At Risk?

The risk factors of heart murmurs are as follows.

People who have suffered from rheumatic fever in the past are more likely to have heart murmurs.
You have endocarditis when an infection in your heart's lining occurs.
If you have high blood pressure that is not controlled, you are at high risk of a heart murmur.
If someone in your family has or has a heart defect, there is a chance that you might have a heart murmur.
People who have rheumatoid arthritis are at a higher risk of heart murmurs.
If you have pulmonary hypertension, you might have a heart murmur in the future.
People who have systemic lupus erythematosus, hyperthyroidism, or hypereosinophilic syndrome are more likely to have heart murmurs.
Your chances of getting heart murmurs are high if you have carcinoid syndrome.
People with weak heart muscles are more likely to have heart murmurs.
If you are pregnant, then conditions such as uncontrolled diabetes can increase your baby's risk of having heart murmurs. The use of drugs or some types of medicines can lead to heart murmurs.

Steps to Prevent Heart Murmur

It is not possible to prevent heart murmurs, especially when you have heart murmurs caused by congenital heart defects. However, you can do something to ensure that you do not have heart murmurs in the future in some cases. Since heart valve diseases cause heart murmurs, you can ensure that you take precautionary measures to ensure you don't develop heart valve disease. If you can treat underlying problems of heart murmurs, then you can prevent heart murmurs. Sometimes, you can stop the heart murmur from taking place.

You can prevent heart valve disease by getting prompt treatment when you think you might have a strep infection. Another way to prevent heart valve disease is to switch to healthy habits. These habits include regular exercise and eating a well-balanced and nutritious diet. Since these can lower your cholesterol and blood pressure levels, they help prevent valve diseases. Your doctor might prescribe medicines that can help prevent heart murmurs. Your doctor may ask you to make lifestyle changes that will enable the prevention of heart valve diseases.

Instead of focusing on all types of heart valve disease, you can focus on preventing the types that you are at risk for. Your doctor can help you pinpoint which types of heart valve diseases you are most at risk for and how to prevent those diseases from occurring. It can help avoid heart murmurs in the future.

Diagnosis And Treatment of Heart Murmur

Diagnosis of heart murmurs

There are different types of heart sounds. How do you determine what a heart murmur sounds like? Your doctor can detect heart murmurs and their type when he listens to your heartbeat using a stethoscope. If you have a physical exam, your doctor will be able to detect any heart murmurs during that time. Various factors will help your doctor determine whether the heart murmur is an innocent heart murmur or an abnormal heart murmur. One of the factors is how high-pitched or low-pitched the heart murmur is.

Another factor that helps your doctor determine whether the heart murmur is innocent or abnormal is how loud the heart murmur is. Your doctor notes how loud the murmur is on a scale of 1 being the lowest and six being the highest. Your doctor will check where the heart murmur is coming from by determining where it can be heard. Your doctor will decide if changing your body's position and exercising affects the sound or the heart murmur. An important factor that your doctor will discover is how long the murmur is taking place and when it occurs.

If you have a diastolic murmur, whereby the heart murmur takes place when blood fills your heart, it might indicate an underlying heart problem. If you have a continuous murmur whereby the heart murmur occurs during a heartbeat, it might indicate a heart problem, too. Systolic murmurs are usually innocent heart murmurs but, at times, can indicate a problem in your heart. If, by this time, your doctor suspects that you have an abnormal heart murmur, he might suggest that you have extra tests done to find out the exact cause of the problem. These tests are as follows.

Your doctor uses a blood test to check if you have any infection. It is usually for people who might have pericarditis or endocarditis.
An echocardiogram helps your doctor see how your heart structure and function, as well as whether there are any abnormal heart valves.
A chest X-ray helps your doctor look at your blood vessels, heart, and lungs. It can help to see if your heart has become prominent due to any problem.
Your doctor uses cardiac catheterization to measure the pressure available in your heart's chambers. A dye can also be used to see how blood flows through your heart and how your heart valves and blood vessels function.
An electrocardiogram, or ECG, measures electrical impulses and signals. It helps your doctor determine whether you have heart structure or rhythm problems.
A Doppler echocardiography helps your doctor view the pattern of how the blood flows.

Apart from these tests, your doctor might order other tests to be performed based on your heart problem.

Treatment of heart murmurs

If you are diagnosed with an innocent heart murmur, there are chances that you won't require any treatment since there is no potential threat. If innocent murmurs have occurred because of a condition such as fever, the heart murmurs will stop once treatment is given. If your doctor diagnoses you with an abnormal heart murmur, then two things can happen. Your doctor might want to monitor you for some time to see how the condition progresses. If it doesn't pose a threat, no treatment might be required. Another option is treatment.

Two types of treatment can be given - medicines or surgery. Medications prescribed by your doctor will be for treating the heart problem causing the heart murmurs. You might be prescribed statins that help lower cholesterol levels in your body. Heart murmurs can be made worse when you have a high cholesterol level in your body. Your doctor might prescribe diuretics, which are water pills. These are used to remove extra fluid from your body, which can lead to worsening heart murmurs. Beta-blockers can be prescribed to lower heart rate and manage blood pressure.

Your doctor can prescribe anticoagulants to prevent the formation of blood clots. Clopidogrel and warfarin are often prescribed so that blood clots don't form in your heart, as these can lead to stroke. Your doctor might prescribe ACE inhibitors, which help reduce blood pressure. These are just some of the common types of medications that your doctor can prescribe. Your doctor might recommend other medications depending on your condition and which heart problem you are suffering from. Antibiotics can be recommended to prevent an infection from occurring in the heart.

Heart valve problems cannot be treated with medicines alone. At times, surgery is necessary to treat heart valve disease. If valve repair is the best treatment option for you, your doctor can recommend any of the following procedures.

Annuloplasty is a procedure used when there is an abnormal valve opening in your heart. Your doctor performs surgery to tighten the tissue surrounding the valve using an artificial ring. Once this is done, the cusps of the valve can fit perfectly together and close like they normally should.

If you have a faulty cusp, your doctor can recommend valve leaflet repair. Depending on the required repair type, he can do this in various ways. Your doctor can cut the cusp so that it operates properly. Otherwise, he might separate the cusps through surgery or pleat the cusp or leaflet.

Balloon valvuloplasty is a medical procedure for treating a narrow valve. In this surgery, a small catheter is used, and a balloon is attached to the end. Your doctor threads the catheter and guides it to your heart to properly place it inside the valve. The balloon is inflated so the narrow valve becomes more expansive, and normal blood flow can occur.

Structural support repair is used when structural support needs to be repaired. This is done by shortening the papillary muscles and the chordae tendineae or by replacing the cords that support your heart valves. It is generally used to alleviate the leakage that can sometimes occur due to a heart valve problem.

If the valve repair option is not right for you, your doctor might recommend you have your valve replaced.

Transcatheter aortic valve replacement, or TAVR, is a minimally invasive procedure your doctor can recommend. In this surgery, a mechanical valve replaces the aortic valve. This approach is made by making a small incision in your chest. Another option for performing TAVR is to use a catheter. This type of surgery is not the first option because doctors recommend it to those people who suffer from severe aortic valve stenosis and who are not good candidates for aortic valve stenosis.

Open-heart surgery is another option that your doctor might recommend. Doctors most often recommend this. It is used for treating severe valve stenosis. A tissue valve replaces a valve in your heart that has become narrow. Tissue valves can come from someone who has died or from animals such as a cow or a pig. Tissue valves need replacement eventually. It is possible to use an autograft at times. A mechanical valve can be used instead of a tissue valve, but it requires you to take blood thinners because it has the risk of blood clot formation.

You and your doctor will discuss the available treatment options. The best choice depends on various factors, and you should decide promptly. Instead, you should speak to your doctor openly about your fears and any questions that you might have regarding the treatments that you can choose from. Remember to ask your doctor why he recommends a certain treatment option and how it can impact your life in the future.

Outlook And Prognosis

Children and adults with innocent heart murmurs have an excellent outlook since they are harmless and usually go away on their own. For other heart murmur types, the prognosis depends on the type of underlying problem, the severity of the problem, and treatment. When you get prompt treatment, the prognosis is favourable, so timely diagnosis and prompt treatment are necessary for heart murmurs. Your doctor will tell you about your outlook and prognosis depending on your condition of heart murmurs and the treatment.

Road To Recovery And Aftercare

Your doctor will let you know about how you can recover and how to take care of yourself. Certain medications might be prescribed at first, and at other times, you might need to undergo surgical treatments. Your recovery rate will depend on your age, whether you have other heart conditions, overall physical health, and whether you are willing to make any lifestyle changes. You should follow a specific diet and lifestyle after treatment; if you follow what your doctor says, you might heal faster. Asking your doctor about precautions and how you can recover is a good idea.