Heart Murmur

What is it?

Heard through a stethoscope during a physical exam, a murmur is simply an extra heart sound. There are two types of heart murmurs: innocent (harmless) and abnormal. People who have innocent heart murmurs have normal hearts, and usually have no other signs or symptoms of heart problems. Innocent murmurs are common in healthy children. People who have abnormal murmurs may have other signs or symptoms of heart problems. Most abnormal murmurs in children are due to congenital heart defects, while in adults, abnormal murmurs are most often due to heart valve problems caused by infection, disease, or aging.

Key points:

• An abnormal heart sound caused by turbulent blood flow through the heart valves, chambers and major vessels
• Classified as innocent or abnormal, systolic or diastolic and graded on a scale of severity from 1-6
• Other features include “location,” “shape,” “pitch,” and “quality”
• 40-45% of children will exhibit a murmur at some point on exam
• Incidence in adults falls to 10%
• More common to hear an innocent murmur during pregnancy
• Causes of abnormal murmurs include congenital malformation, infection, disease, or aging
• Can indicate improper function of a heart valve or stenosis (narrowing) of a major blood vessel, but are often ruled benign
• Patients with heart murmurs will be offered antibiotics when getting dental work

How do we treat it?

While innocent murmurs do not require treatment, abnormal murmurs can indicate serious cardiovascular pathology. Treatment will depend on proper identification and diagnosis. So, initially, we will recommend that you do a series of lab tests including perhaps an echocardiogram, an ultrasound of your heart. This examination will show us a picture of your heart beating and any abnormal flow of blood will be observable.

For murmurs caused by physical deformities, treatment will include optimization of all other heart function to minimize the long term consequences of this condition on your health. For murmurs related to infection, high blood pressure, pregnancy, fever or anemia, our approach will focus on the specific cause. And, ultimately, it will be important to figure out why the consequence of your chronic health problem landed in your heart.