17083 Heart Murmur

Overview

A heart murmur is an extra sound that your doctor hears when listening to your heart with a stethoscope. It is the sound of blood flowing through the heart in a way that is slightly different from normal. Most heart murmurs are harmless and are not a sign of a problem, but some may be caused by a heart condition that needs monitoring or treatment.

Heart murmurs are very common. Many people, including children and adults, have a murmur at some point in their lives. Most are innocent and do not cause any health problems.

Heart murmurs can affect people of any age, from babies to older adults. They are often found during a routine checkup. In children, most murmurs are harmless and go away on their own. In adults, murmurs may develop later in life, especially if a heart valve becomes stiffer or leakier with age.

Symptoms

Common symptoms

• Most people with a harmless heart murmur have no symptoms at all.
• If a murmur is caused by a heart problem, possible symptoms include shortness of breath, chest pain, feeling tired easily, or swelling in the legs or ankles.

Symptoms in children

• Poor feeding and slow weight gain in babies
• Breathlessness during feeding or activity
• Blue or gray color around the lips or skin
• Fainting or dizzy spells

Symptoms in older adults

• Shortness of breath during light activity or when lying down
• Swelling in the feet, ankles, or legs
• Palpitations (feeling like your heart is racing or skipping beats)
• Dizziness or fainting

Causes

Main causes

• Increased blood flow through the heart, for example during exercise, pregnancy, or fever — this is called an innocent or flow murmur.
• A heart valve that does not open or close properly, causing blood to leak backward or be partly blocked.
• A hole in the heart, which is a birth defect that allows blood to flow between chambers that should not be connected.
• Inflammation of the heart lining or heart muscle, such as from an infection.
• Changes to the heart's structure that can happen with age.

Risk factors

• Being born with a heart condition
• A family history of heart murmurs or heart valve problems
• Past rheumatic fever (a condition that can damage heart valves)
• High blood pressure
• Advanced age, as heart valves can naturally thicken or stiffen over time

When to see a doctor

See a doctor urgently if:

• If you have chest pain, trouble breathing, fainting, or a racing heartbeat, call your local emergency number right away.
• If you notice sudden swelling in your legs, or you feel very dizzy and weak, seek same-day medical care.

Book a routine appointment if:

• If you were told you have a heart murmur and you have not had it checked in a while, make an appointment with your doctor.
• If you have had a heart murmur in the past and you start to feel unusual tiredness, shortness of breath, or heart palpitations, see your doctor.
• If your child has a heart murmur and you are worried about feeding, growth, or energy levels, ask your doctor.

Diagnosis

A doctor usually finds a heart murmur by listening to your heart with a stethoscope. Based on the loudness, timing, and location of the murmur, the doctor can decide whether it sounds innocent or whether more tests are needed.

Tests that may be done

• Echocardiogram (an ultrasound scan of the heart) to see the heart's structure and blood flow
• Electrocardiogram (ECG or EKG) to check the heart's electrical activity and rhythm
• Chest X-ray to look at the size and shape of the heart
• A blood test to check for signs of infection, anemia, or other conditions that can affect the heart

What to expect at your appointment

If your doctor thinks the murmur might be due to a heart problem, they will likely refer you to a cardiologist (a heart specialist). You may have an echocardiogram, which is a painless scan using sound waves. The test usually takes under an hour, and you can go home afterwards. The results will help the specialist tell you whether the murmur is harmless or whether you need any follow-up.

Treatment

Most heart murmurs do not need any treatment because they are innocent. If a murmur is caused by an underlying heart condition, treatment will depend on what that condition is and how severe it is. The goal is to manage symptoms, prevent complications, and keep your heart as healthy as possible.

Self-care at home

• Keep your regular appointments with your doctor or heart specialist, even if you feel fine.
• Tell your doctor or dentist about your heart murmur, especially if you are having any procedure or surgery, because in some cases antibiotics may be needed before certain procedures to prevent infection.
• Stay physically active at a level that feels comfortable for you. Unless your doctor says otherwise, you do not need to limit your activity.
• Quit smoking and avoid recreational drugs, because they can put extra strain on your heart.
• Watch for new symptoms such as breathlessness, chest pain, or swelling, and report them promptly.

Medical treatments

If your heart murmur is due to a heart condition that needs treatment, your doctor might recommend medicines to help the heart pump more effectively, lower blood pressure, reduce fluid buildup, or prevent blood clots. The exact medicine will depend on your specific condition and is prescribed by your doctor. Never take any medicine for a heart murmur without speaking to a qualified healthcare provider.

When is surgery considered?

Surgery is not needed for most heart murmurs. But if the murmur is caused by a severely damaged heart valve, a birth defect, or other structural heart problem that is affecting your health, your doctor may recommend a procedure or surgery to repair or replace a valve or to correct the defect. This is usually done only after a thorough evaluation by a specialist.

Living with this condition

For most people, a heart murmur does not change daily life. You can go to work, exercise, travel, and enjoy everyday activities. If your murmur is due to a heart condition, follow your healthcare team's advice about how to stay active and when to check in with them.

Lifestyle tips

• Maintain a healthy weight to reduce extra strain on your heart.
• If you drink alcohol, do so in moderation — ask your doctor what is safe for you.
• Manage stress with relaxation techniques, deep breathing, or activities you enjoy.
• Get enough sleep and try to keep a regular routine.
• Know your heart numbers — blood pressure, cholesterol, and pulse — and have them checked regularly.

Diet and exercise

Eat a balanced diet rich in vegetables, fruits, whole grains, and lean proteins while limiting salt, sugar, and unhealthy fats. Exercise is safe for most people with a murmur. Walking, swimming, and gentle cycling are excellent choices. If you have an underlying heart condition, ask your doctor which exercises are best for you and whether you need any activity limits.

Mental health and emotional wellbeing

Hearing that you have a heart murmur can make you feel worried or anxious. This is natural. For many people, the murmur turns out to be harmless, and knowing that can bring relief. If anxiety about your heart is affecting your sleep, mood, or daily activities, talk to your doctor. You can also consider speaking with a counsellor or psychologist. Remember that your emotional health is just as important as your physical health.

Prevention

You cannot prevent a heart murmur itself, because many are simply the sound of blood flowing normally. However, you can reduce the risk of heart conditions that can cause murmurs by eating a heart-healthy diet, staying active, not smoking, and controlling blood pressure.

Vaccines

There is no vaccine for a heart murmur, but staying up to date with recommended vaccines, such as the flu vaccine and pneumococcal vaccine, can help protect your heart from infections. Ask your doctor or pharmacist which vaccines you should have.

Screening programmes

There is no routine screening test for heart murmurs in adults. Most are found by chance when a doctor listens to the heart during a general checkup. If you have risk factors for heart disease or a family history of heart conditions, your doctor may suggest regular checkups that include listening to your heart.

Complications

If left untreated

• An innocent murmur does not cause complications and does not need treatment.
• If a murmur is due to a heart valve problem, and it is severe and not treated, it can lead to heart failure, an enlarged heart, or an irregular heartbeat over time.
• In rare cases, a heart infection (endocarditis) can develop, which can damage the heart valves further.

Long-term outlook

The outlook for most people with a heart murmur is excellent. Innocent murmurs do not affect your health or lifespan. Even if a murmur is caused by a heart condition, modern treatments and regular follow-up can help you live a full, active life. With the right care, most people manage well and remain healthy for many years.

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