Causes and Treatment of Heart Murmurs

A normal heartbeat makes two sounds that sound somewhat like a “lubb-dupp” noise to the human ear. Heart murmurs, however, describe a case in which whooshing or swishing sounds are made by the heartbeat. Heart murmurs are caused by turbulent blood in or near the heart, and they can either be present at birth or develop later on in life. While heart murmurs are not considered a disease per se, they can indicate an underlying health problem. In other cases, heart murmurs are harmless and do not require treatment. 

Signs and Symptoms

In cases of harmless heart murmurs, also called innocent heart murmurs, you likely won’t have any additional symptoms beyond the abnormal noise created by the heartbeat. If any of the following signs are present as well, though, this is an abnormal heart murmur that could signal a problem:

• Skin that appears blue, particularly on the fingertips or lips
• Swelling or sudden weight gain
• Shortness of breath
• Chronic cough
• Enlarged liver
• Enlarged neck veins
• In infants, poor appetite or failure to grow normally
• Heavy sweating despite little or no exertion
• Chest pain
• Dizziness
• Fainting

 

Most heart murmurs are not serious. If you think your child has a heart murmur, schedule an appointment with your family doctor to find out if this will require treatment or further examination.

Causes and Risk Factors

Heart murmurs are categorized by innocent heart murmurs and abnormal heart murmurs. Innocent murmurs occur in people with a normal heart, and they are common in newborns and children. They can occur when blood flows more rapidly than normal through the heart, which can happen for a variety of reasons:

• Physical activity
• Pregnancy
• Fever
• Anemia (lack of enough healthy red blood cells to carry proper oxygen to body tissues)
• Hyperthyroidism: An excessive amount of thyroid hormone in the body
• Phases of rapid growth, including adolescence

Abnormal heart murmurs, on the other hand, can be more serious. In children, they are generally caused by congenital heart disease—when babies are born with structural issues in the heart. Common congenital defects that cause this include holes in the heart (also called cardiac shunts or septal defects) and heart valve abnormalities that may be present at birth but are discovered later. Other causes of abnormal heart infections are more common for older children and adults, and may include:

• Valve calcification: Hardening or thickening of valves can make it harder for blood to reach the heart.
• Endocarditis: An infection of the inner lining of the heart and valves. Untreated, endocarditis can damage or destroy heart valves.
• Rheumatic fever: This is now rare in the United States, but it’s a serious condition that can occur when prompt treatment for a strep throat infection is not given. This can permanently affect the heart valves and can interfere with normal blood flow through the heart.

People with a family history of a heart defect are at an increased risk of developing heart murmurs. In addition, people with any of the following conditions may be at higher risk:

• Hypertension (high blood pressure)
• Hyperthyroidism
• Endocarditis
• Pulmonary hypertension (high blood pressure in the lungs)
• Carcinoid syndrome
• Hypereosinophilic syndrome
• Systemic lupus erythematosus
• Rheumatoid arthritis
• Weakened heart muscle
• History of rheumatic fever

Factors that increase your baby’s risk of pregnancy include illnesses like uncontrolled diabetes or rubella infections during pregnancy, or certain medications or illegal drugs taken during pregnancy.

Diagnosis and Treatment

Heart murmurs can usually be diagnosed by a simple exam where your doctor uses a stethoscope to listen to your heart. Determining whether it’s innocent or abnormal is a process that involves several questions and potentially several additional tests.

In cases of an innocent heart murmur, treatment isn’t generally needed. If innocent murmurs are the result of an underlying condition, the murmurs will go away once the condition is properly treated.

For abnormal murmurs, however, treatment may be necessary. There are a couple possible treatments for heart murmurs:

• Medications: This depends on the specific heart issue you have. Medications can include anticoagulants to prevent blood clots, diuretics, ACE inhibitors for blood pressure, statins for cholesterol, or beta blockers to lower heart rate and blood pressure.
• Surgery: This may include valve repair or full valve replacement, which would include open-heart surgery.

There isn’t much you can do to prevent heart murmurs. Many heart murmurs in children go away as children get older, and for adults, improving the underlying condition associated with heart murmurs will often improve the murmurs themselves.

If you or your child has a heart murmur, your doctor can offer recommendations for treatment.

 

Sources:

“Heart murmurs.” The Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/heart-murmurs/basics/definition/con-20028706

“What Are Heart Murmurs?” WebMD. https://www.webmd.com/heart-disease/guide/heart-murmur-causes-treatments#1