[HALEY]

Heart murmurs — Comprehensive overview covers symptoms, causes, treatments of abnormal heart sounds.

A normal heartbeat makes two sounds like "lubb-dupp" (sometimes described as "lub-DUB"), which are the sounds of your heart valves closing. Heart murmurs are abnormal sounds during your heartbeat cycle — such as whooshing or swishing — made by turbulent blood in or near your heart.

Heart murmurs can be present at birth (congenital) or develop later in life. A heart murmur isn't a disease — but murmurs may indicate an underlying heart problem.

Most heart murmurs are harmless (innocent) and don't need treatment, but some heart murmurs may require follow-up tests to be sure the murmur isn't caused by a serious underlying heart condition. Treatment, if needed, is directed at the underlying cause of your heart murmurs.

Your heart has two upper and two lower chambers. The upper chambers, the right and left atria, receive incoming blood. The lower chambers, the more muscular right and left ventricles, pump blood out of your heart. The heart valves, which keep blood flowing in the right direction, are gates at the chamber openings.


An abnormal heart murmur usually has no obvious signs, aside from the unusual sound your doctor hears when listening to your heart with a stethoscope. But when these signs or symptoms are present, they may indicate a heart problem:

Skin that appears blue, especially on your fingertips and lips
Swelling
Shortness of breath
Enlarged liver
Enlarged neck veins
Poor appetite and failure to grow normally (in infants)
Weight gain (in adults and children)
Heavy sweating with minimal or no exertion
Chest pain
Dizziness
Fainting
Causes
There are two types are heart murmurs: innocent murmurs and abnormal murmurs. A person with an innocent murmur has a normal heart. This type of heart murmur is common in newborns and children. More than half of all children have heart murmurs at some time, and most of those murmurs are harmless.

An abnormal heart murmur is more serious. In children, abnormal murmurs are usually caused by congenital heart disease. In adults, abnormal murmurs are most often due to acquired heart valve problems.

Innocent heart murmurs
An innocent murmur can occur when blood flows more rapidly through the heart. Conditions that may cause rapid blood flow through your heart, resulting in an innocent heart murmur, are:

Physical activity or exercise
Pregnancy
Fever
Anemia, in which there aren't enough healthy red blood cells to carry adequate oxygen to your body tissues
Hyperthyroidism, an excessive amount of thyroid hormone in your body
Changes to the heart due to aging or heart surgery also may cause an innocent heart murmur. Over time, innocent heart murmurs may disappear, or last your entire life without ever causing further health problems.

Abnormal heart murmurs
Although most heart murmurs aren't serious, some may result from a heart problem. The most common cause of abnormal murmurs in children is congenital heart disease — when babies are born with structural heart defects. Common congenital defects that cause heart murmurs include:

Holes in the heart or cardiac shunts. Many heart murmurs in children are the result of holes in the walls between heart chambers, known as septal defects. These may or may not be serious, depending on the size of the hole and its location. There are two types of septal defects. A ventricular septal defect is a hole between the lower chambers of the heart. Atrial septal defects are holes between the upper chambers. Shunts occur when there's an abnormal blood flow between the heart chambers or blood vessels, leading to a heart murmur.
Heart valve abnormalities. Congenital heart valve abnormalities are present at birth, but sometimes aren't discovered until much later in life. Examples include valves that don't allow enough blood through them (stenosis) or those that don't close properly and leak (regurgitation).
Other causes of abnormal heart murmurs include infections and conditions that damage the structures of the heart and are more common in older children or adults. For example:

Rheumatic fever. Although rare in the United States, rheumatic fever is a serious inflammatory condition that can occur when you don't receive prompt or complete treatment for a strep throat infection. In many cases, rheumatic fever may permanently affect the heart valves and interfere with normal blood flow through your heart. Prompt and proper treatment of strep throat with antibiotics can prevent strep throat from progressing to rheumatic fever.
Endocarditis. This is an infection and inflammation of the inner lining of your heart and valves. Endocarditis typically occurs when bacteria or other germs from another part of your body, such as your mouth, spread through your bloodstream and lodge in your heart. Left untreated, endocarditis can damage or destroy your heart valves. This condition usually occurs in people who already have heart abnormalities.
Valve calcification. This hardening or thickening of valves, called mitral or aortic valve stenosis, can occur as you age. These valves may not work as well as they once did, making it harder for blood to flow through your heart, resulting in murmurs.
Mitral valve prolapse. In this condition, the valve between your heart's left upper chamber (left atrium) and the left lower chamber (left ventricle) doesn't close properly. When the left ventricle contracts, the valve's leaflets bulge (prolapse) upward or back into the atrium, which may cause a murmur. This condition is sometimes present at birth, but not detected until adulthood.
Tests and diagnosis
Heart murmurs are usually detected when your doctor listens to your heart using a stethoscope during a physical exam.

To determine whether the murmur is innocent or abnormal, your doctor will consider:

How loud is it? This is rated on a scale from 1 to 6, with 6 being the loudest.
Where in your heart is it? And can it be heard in your neck or back?
What pitch is it? Is it high-, medium- or low-pitched?
What affects the sound? If you change your body position or exercise, does it affect the sound?
When does it occur, and for how long? Systolic murmurs occur when your heart is squeezing blood out. Diastolic murmurs are heard when your heart is filling with blood. Continuous murmurs occur during the entire heartbeat cycle. Both diastolic and continuous murmurs often indicate a heart defect or disease that needs more evaluation.
Your doctor will also look for other signs and symptoms of heart problems and ask about your medical history and whether other family members have had heart murmurs or other heart conditions.

Additional tests
If your doctor suspects the heart murmur is abnormal, you may need additional tests .