Heart Murmurs

Heart sounds, like whooshing or swishing noises, can sometimes be heard when blood moves quickly and unevenly through the heart. A doctor can listen to these sounds using a stethoscope. A healthy heart usually makes two sounds, "lubb-dupp," which happen when the heart's valves close.

These whooshing sounds, or murmurs, can be present from birth (a condition called congenital) or develop later in life (acquired).

Some murmurs are completely normal and don't mean there's anything wrong with the heart (called innocent murmurs). These don't need any treatment. Other murmurs might be a sign of a more serious problem with the heart's structure or function. In these cases, further tests are necessary to determine the precise cause and what, if any, treatment is needed. The treatment for a heart murmur depends entirely on the reason why it's there.

Some heart murmurs are completely normal and don't cause any problems. These are called harmless murmurs.

However, other heart murmurs can be a sign of a more serious underlying condition. The symptoms of these worrisome murmurs depend on the specific cause. If you notice any of these symptoms, it's important to see a doctor:

• Changes in skin color: Bluish or grayish coloring of your fingernails or lips.
• Chest pain: This can be a sign of a problem with the heart.
• Persistent cough: A cough that won't go away could indicate a heart issue.
• Dizziness: Feeling lightheaded or dizzy can be a symptom of various health problems, including heart conditions.
• Swollen liver or neck veins: This swelling might signal fluid buildup, a possible sign of heart problems.
• Fainting: Passing out can be a symptom of a serious health problem, including those affecting the heart.
• Excessive sweating: Heavy sweating, especially during periods of inactivity, could be a sign of a heart condition.
• Problems in infants: In babies, poor eating habits, and a lack of normal weight gain can be a warning sign.
• Shortness of breath: Difficulty breathing, even with minimal exertion, is a significant symptom that needs attention.
• Swelling and weight gain: Sudden swelling in the body, especially the ankles or feet, along with rapid weight gain, can be a sign of fluid buildup, which is sometimes linked to heart problems.

It's crucial to remember that this list is not exhaustive, and other symptoms might also be present. If you experience any of these symptoms, it's essential to consult a doctor for proper diagnosis and treatment.

Many heart murmurs are not a cause for worry. If you hear a sound in your chest that you think might be a heart murmur, it's a good idea to schedule a visit with your doctor. Your doctor can determine if further tests or treatment are necessary. They can explain what the sound means and whether you need to see a specialist.

A heart murmur happens when blood flows through your heart in a fast, irregular way. This irregular flow creates a sound, like a whoosh or a swish, that a doctor can often hear with a stethoscope. This sound is called a heart murmur.

Heart murmurs can happen at different stages of the heartbeat:

• During the filling stage (diastole): This is when the heart chambers relax and fill with blood. A murmur during this time means the blood isn't flowing smoothly into the heart, perhaps because of a problem with a heart valve.

• During the pumping stage (systole): This is when the heart chambers contract and push blood out to the body. A murmur during this stage could mean the blood isn't flowing smoothly out of the heart, possibly due to a leaky or narrowed valve.

• Throughout the entire heartbeat (continuous murmur): This means the murmur is present all the time, not just during one part of the heartbeat. This type of murmur is often a sign of a blood vessel problem within the heart, such as a blood vessel that's not closing properly.

In short, a heart murmur is caused by unusual blood flow patterns within the heart, which produce a sound that doctors can detect. This unusual flow can be a sign of a problem with the heart valves or other structures in the heart.

Heart murmurs in babies can be linked to several factors. A family history of heart problems can increase the risk. If a pregnant mother has uncontrolled diabetes, this can also raise the chances. Exposure to German measles (rubella) during pregnancy is another risk factor. Finally, the use of certain medications, alcohol, or illegal drugs during pregnancy can contribute to the development of a heart murmur.

Beyond these factors related to pregnancy, other medical conditions can also increase the risk of heart murmurs. For example, a rare cancer called carcinoid syndrome, where a tumor releases harmful substances into the bloodstream, can be a contributing factor. A weakened heart muscle (cardiomyopathy) can also lead to murmurs. An infection of the heart's inner lining (endocarditis) can also play a role.

Other conditions that can increase the risk include anemia (a lack of red blood cells), blood disorders with unusually high levels of white blood cells called eosinophils (hypereosinophilic syndrome), and certain autoimmune disorders like lupus and rheumatoid arthritis. Problems with the heart valves, high blood pressure in the lungs (pulmonary hypertension), a history of rheumatic fever, and an overactive thyroid (hyperthyroidism) can all be associated with an increased risk of heart murmurs in babies. In short, various health conditions in the mother or baby can potentially lead to the presence of a heart murmur.

Heart murmurs can't be prevented in a direct way. However, leading a healthy lifestyle can help improve overall heart health. This, in turn, can reduce the risk of some conditions that might be associated with heart murmurs. Many heart murmurs in children disappear as they get older and grow.

A heart murmur is an extra sound sometimes heard when a doctor listens to your heart with a stethoscope. It's often found during a routine checkup for something else entirely. Your doctor will ask about your medical history and your family's, too.

Doctors use a stethoscope to listen to your heart. They look for several clues to determine if the murmur is a cause for concern. These clues include:

• Loudness: How loud is the murmur? A scale of 1 to 6 is used, with 6 being the loudest.
• Location: Where in your chest do you hear the murmur? Does the sound travel to your neck or back?
• Pitch: Is the sound high-pitched, medium-pitched, or low-pitched?
• When it happens: A murmur that happens as blood is pumped out of the heart (systolic murmur) is often harmless. But a murmur that occurs while the heart fills with blood (diastolic murmur) or throughout the entire heartbeat (continuous murmur) might indicate a problem.
• How it changes: Does the murmur sound different when you exercise or change positions?

If a murmur seems concerning, further tests are needed to find the cause. These tests might include:

• Echocardiogram: This is a common test for heart murmurs. It uses sound waves to create a picture of your heart, showing how blood flows through it and how your heart valves work.
• Chest X-ray: This creates a picture of your heart and lungs, helping to see if your heart is enlarged. An enlarged heart can sometimes cause a murmur.
• Electrocardiogram (ECG or EKG): This painless test measures the heart's electrical activity. Sensors (electrodes) are placed on your chest, arms, and sometimes legs, and connected to a machine that records the results. The doctor looks at the patterns to check for any heart problems.
• Cardiac Catheterization: This test is used when other tests don't pinpoint the cause of the murmur. A thin, flexible tube (catheter) is inserted into a blood vessel in your arm or groin, guided to your heart. A special dye might be used to help see the blood vessels more clearly on the images taken during the procedure.

These tests help doctors determine the cause of the murmur and recommend the best course of treatment, if needed. Remember, many heart murmurs are harmless, but it's always best to get any concerns checked by a healthcare professional.

Many people experience heart murmurs, which are unusual sounds the heart makes. Most heart murmurs are harmless and don't require treatment. If a fever or an overactive thyroid (hyperthyroidism) is present, the murmur often goes away once the underlying condition is treated.

However, some murmurs are more concerning. These "worrisome" murmurs need careful monitoring by a doctor. The treatment for these murmurs depends entirely on the cause. A doctor will investigate the underlying reason for the murmur and recommend the best approach. This might involve medications or, in some cases, surgery.

Several types of medication can be used to treat heart conditions linked to murmurs:

• Blood thinners (anticoagulants): These prevent blood clots. Some heart conditions causing murmurs are related to irregular heartbeats, which can lead to blood clots. Blood clots increase the risk of stroke. Common blood thinners include warfarin, clopidogrel, apixaban, rivaroxaban, and dabigatran.

• Water pills (diuretics): These remove excess fluid from the body. Doctors might prescribe diuretics to manage high blood pressure or other conditions that can make the heart murmur worse.

• Angiotensin-converting enzyme (ACE) inhibitors: These medications lower blood pressure. High blood pressure can worsen the conditions that cause heart murmurs.

• Beta blockers: These medications slow the heart rate and lower blood pressure. This is helpful if an underlying condition is causing the heart to work too hard.

In the past, doctors often recommended antibiotics before any surgery or dental work for people with worrisome heart murmurs. This practice has changed. Antibiotics are now only recommended in very specific situations. These situations include people with artificial heart valves, a history of heart infections in their heart valves, or congenital heart defects that put them at a higher risk of infection.

Sometimes, surgery is necessary to correct the problem causing the worrisome murmur. If a heart valve is narrowed or leaking, for example, surgery to repair or replace the valve may be needed.

During heart valve repair, a surgeon might:

• Patch holes in the valve.
• Separate fused valve leaflets (the flaps of the valve).
• Replace the cords that support the valve (chordae tendineae).
• Remove excess valve tissue to make the valve close properly.
• Tighten or reinforce the ring around the valve (annulus).

Heart valve surgery can be performed in several ways, depending on the specific situation:

• Open-heart surgery: A traditional, more extensive approach.
• Minimally invasive heart surgery: Involves smaller incisions and less invasive procedures.
• Robotic heart surgery: Uses robotic arms and tools for the procedure.
• Catheter procedures: Involve inserting flexible tubes (catheters) into the heart to perform the necessary work.

The best approach to treating a worrisome heart murmur is determined by the specific cause and the individual's overall health.