Medical knowledge, Patient Education

Heart Murmur

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A heart murmur is an extra sound that is caused by turbulent blood flow through the valves of the heart. The murmur can be heard as a “hum” or “whoosh” sound when blood flows through the heart.

The heart has four areas called chambers. There is a valve for each chamber for the heart. Blood passes through a valve before leaving the chamber. Two of the valves move the blood from the upper chambers of the heart to the lower chambers of the heart (tricuspid valve and mitral valve). The other two valves (aortic valve and pulmonary valve) move the blood to the lungs and the rest of the body.

The valves keep blood moving through the heart in the right direction. When the heart valves are not working properly it may cause a murmur.

There are two types of heart murmurs:

  • Innocent (benign) murmurs. Most people with this type of heart murmur do not have a heart problem. Many children have innocent heart murmurs. Your health care provider may suggest some basic tests to find out whether your murmur is an innocent murmur. If an innocent heart murmur is found, there is no need for further tests or treatment and no need to restrict activities or stop playing sports.

  • Abnormal murmurs. These types of murmurs can occur in children and adults. Abnormal murmurs may be a sign of a more serious heart condition, such as a heart abnormality present at birth (congenital defect) or heart valve disease.

What are the causes?

Anatomy of the heart showing the tricuspid valve, aortic valve, pulmonary valve, and mitral valve.
This condition may also be caused by:

  • Pregnancy.

  • Fever.

  • Overactive thyroid gland.

  • Anemia.

  • Exercise.

  • Rapid growth spurts in children.

What are the signs or symptoms?

Innocent murmurs do not cause symptoms, and many people with abnormal murmurs may not have symptoms. If symptoms do develop, they may include:

  • Shortness of breath or persistent cough.

  • Blue coloring of the skin, especially on the fingertips.

  • Chest pain.

  • Palpitations, or feeling a fluttering or skipped heartbeat.

  • Fainting.

  • Getting tired much faster than expected.

  • Swelling in the abdomen, feet, or ankles.

How is this diagnosed?

This condition may be diagnosed during a routine physical or other exam. If your health care provider hears a murmur with a stethoscope, he or she will listen for:

  • Where the murmur is located in your heart.

  • How loud the murmur is. This may help the health care provider figure out what is causing the murmur.

You may be referred to a heart specialist (cardiologist). You may also have other tests, including:

  • Electrocardiogram (ECG or EKG). This test measures the electrical activity of your heart.

  • Echocardiogram. This test uses high frequency sound waves to make pictures of your heart.

  • Chest X-ray.

  • Magnetic resonance imaging (MRI).

  • Cardiac catheterization. This test looks at blood flow through the arteries around the heart.

For children and adults who have an abnormal heart murmur and want to stay active, it is important to:

  • Complete testing.

  • Review test results.

  • Receive recommendations from your health care provider.

If heart disease is present, it may not be safe to play or be involved in activities that require a lot of effort and energy (are strenuous).

How is this treated?

Heart murmurs themselves do not need treatment. In some cases, a heart murmur may go away on its own. If an underlying problem or disease is causing the murmur, you may need treatment. If treatment is needed, it will depend on the type and severity of the disease or heart problem causing the murmur. Treatment may include:

  • Medicine.

  • Surgery.

  • Changes to your lifestyle and diet.

Follow these instructions at home:

  • Talk with your health care provider before participating in sports or other activities that are strenuous.

  • Learn as much as possible about your condition and any related diseases. Ask your health care provider if you may be at risk for any medical emergencies.

  • Talk with your health care provider about what symptoms you should look out for.

  • It is up to you to get your test results. Ask your health care provider, or the department that is doing the test, when your results will be ready.

  • Keep all follow-up visits. This is important.

Contact a health care provider if:

  • You are frequently short of breath.

  • You feel more tired than usual.

  • You are having a hard time keeping up with normal activities or fitness routines.

  • You have swelling in your ankles or feet.

  • You notice that your heart often beats irregularly.

  • You develop any new symptoms.

Get help right away if:

  • You have chest pain.

  • You are having trouble breathing.

  • You feel light-headed or you faint.

  • Your symptoms suddenly get worse.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

  • Heart valves keep blood moving through the heart in the right direction. When the valves are not working properly it may cause a murmur.

  • Innocent murmurs do not cause symptoms, and many people with abnormal murmurs may not have symptoms.

  • You may need treatment if an underlying problem or disease is causing the heart murmur. Treatment may include medicine, surgery, and changes to your lifestyle and diet.

  • Talk with your health care provider before participating in sports or other activities that are strenuous.

  • Get help right away if you have chest pain or trouble breathing.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

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