Recognizing Heart Murmurs: Types, Symptoms & Treatments

Each heartbeat generates audible sounds, emanating from the opening and closing of the heart valves, which can be detected using medical devices. Clinicians employing a stethoscope or similar instruments may identify a heart murmur if they observe any deviations or inconsistencies in the heart's rhythm. Heart murmurs are categorized as either innocent or abnormal and may be congenital or acquired throughout one's lifetime.

1. Innocent Heart Murmurs

In certain individuals, such as newborns or growing children, a heart murmur may be detected and is often considered benign. This phenomenon, referred to as an "innocent" heart murmur, is attributed to the hastened flow of blood through the heart chambers. Factors like physical exercise, pregnancy, or periods of rapid growth can prompt this harmless condition. Similarly, fever, anemia, or hyperthyroidism can induce an innocent murmur. While it may persist over a lifetime, an innocent heart murmur typically does not pose any significant health risks or stem from underlying health issues.

2. Abnormal Heart Murmurs in Children

An innocent heart murmur typically differs from an abnormal one in clinical significance. Abnormal murmurs often arise in children with structural heart conditions, such as congenital septal defects or cardiac shunts, leading to irregular circulatory patterns. It is noteworthy that if a murmur diminishes when the child stands, this can indicate the absence of a pathological murmur. This distinction is critical in the pediatric assessment for potential congenital heart diseases.

3. Abnormal Heart Murmurs in Adults

Adults may experience the onset of abnormal heart murmurs due to acquired valvular heart conditions. These murmurs can also originate from congenital anomalies, which, despite being present from birth, may remain undetected into adulthood. Two prevalent forms of these valvular dysfunctions are stenosis, characterized by restricted blood flow due to narrowed valves, and regurgitation, wherein the valves fail to seal properly, leading to blood leakage.

4. Other Causes of Abnormal Heart Murmurs

Adults and older children are susceptible to developing abnormal heart murmurs as a result of complications such as infections. Bacterial endocarditis, for example, is a serious condition where bacteria infiltrate the bloodstream and attach to the heart's inner lining, leading to the potential destruction of the heart valves. Additionally, the valves may undergo calcification, becoming stiff, or stenosis, where they narrow and impede blood flow. Furthermore, if strep throat is not appropriately treated, it can escalate to rheumatic fever, which poses a risk of causing irreversible damage to the heart valves.

5. Symptoms

Heart murmurs can be benign or pathological, and may not always lead to symptoms. However, individuals who present symptoms should be attentive, as these may include breathlessness, persistent cough, chest discomfort, episodes of dizziness, and excessive sweating during light activities. Such symptoms could signify a cardiac condition requiring medical evaluation.

6. More Symptoms of Heart Murmurs

Recognizable indicators of cardiac issues may encompass hepatic enlargement, distended cervical veins, edema, and abrupt weight increment. Cyanosis, a blue discoloration of the skin most notable on lips and extremities, may occur, suggesting inadequate blood flow. In pediatric populations, diminished appetite or substandard growth rates can also be indicative of heart complications.

7. When to See a Doctor

Individuals experiencing any of the previously mentioned symptoms or who have concerns regarding their cardiac health are encouraged to consult with a physician. A medical professional can perform an initial assessment using a stethoscope to detect possible murmurs and evaluate their underlying cause and severity. If necessary, the doctor may recommend additional diagnostic tests to formulate an appropriate treatment strategy. While echocardiograms are not typically required for benign heart murmurs, they are recommended for individuals suspected of having valvular heart disease or who exhibit cardiac-related symptoms.

8. Treatments

Individuals with benign heart murmurs typically do not necessitate medical intervention. Certain atypical heart conditions may only require regular observation rather than immediate treatment with medication or surgical procedures. When treatment is essential for a heart murmur, the selected approach will be tailored to address the specific heart issue responsible for the murmur. Depending on the condition, the medical strategy may range from conservative management to the potential necessity for surgical intervention.

9. Medication for Abnormal Heart Murmurs

A cardiologist may prescribe a variety of pharmaceutical treatments for a heart murmur, tailored to its underlying cause. Anticoagulants are utilized to prevent the formation of blood clots in the heart. Diuretics, also known as water pills, are administered to alleviate excess fluid retention. To reduce cholesterol levels, statin medications may be recommended. Beta-blockers are prescribed to decrease blood pressure and heart rate, and they have therapeutic benefits for heart valve issues. Additionally, angiotensin-converting enzyme (ACE) inhibitors are employed to lower blood pressure, further protecting cardiovascular health.

10. Surgery for Heart Murmurs

Patients suffering from compromised heart valves often necessitate treatment beyond pharmacological intervention. There are four principal reparative interventions for damaged valves: balloon valvuloplasty, annuloplasty, leaflet repair, and structural support enhancement. In instances where a valve replacement is indispensable, the surgical options available are traditional open-heart surgery or the less invasive transcatheter aortic valve replacement (TAVR) procedure. A specialized cardiac surgical team will evaluate and determine the most suitable treatment pathway tailored to the individual needs of each patient.