Heart
Murmurs
What
is it?
A heart murmur is an
abnormal, extra sound heard with each heartbeat. Heart
murmurs are classified according to their loudness
and where in the pumping cycle of the heart they
occur. Heart
murmurs that are very faint, intermittent, and
occur in a small area of the chest are called
“innocent” or “functional” heart murmurs. Heart
murmurs that are louder, continual, and
accompanied by a sound like a “click” or
“gallop” are called “pathologic” heart
murmurs. These
may indicate a serious heart defect.
The heart pumps in two phases.
The pumping phase is called “systole.”
The resting phase is called “diastole.”
A systolic heart murmur is one that is
heard during systole, while a diastolic heart
murmur is heard during diastole.
Who
gets it?
Heart murmurs are common in
school-age children.
Studies have shown anywhere from 50 - 90%
of all children have a heart murmur at some time
in their lives.
What
causes it?
A heart murmur is caused by
blood moving through the heart and its valves. The
murmur, which sounds like a “swish,” occurs
when blood flow is noisy or turbulent.
There may be some minor abnormalities of
the lining of the heart chambers that interfere
with the smooth flow of blood.
Or, it could be caused by the shape
of the heart or a valve abnormality. In
a little more than one-half of children with heart
murmurs, the heart is normal and the murmurs are
harmless. However,
heart murmurs can also be caused by congenital
abnormalities, heart infections, or strep
infections that can cause valve damage.
What
are the symptoms?
Innocent heart murmurs have
no symptoms.
They may disappear and reappear throughout
childhood. Heart
murmurs that indicate a more serious condition,
such as congestive heart failure, may cause
symptoms including chest pain; shortness of
breath; dizziness and fainting; bluish tinge to
the skin in the area of the lips, tongue, and
nails; fatigue and difficulty breathing during
exercise; and rapid heart rate.
How
is it diagnosed?
Your doctor will thoroughly
examine your child and ask about his or her growth
and activity level. It
is very easy to tell the difference between an
innocent murmur and a pathologic one by listening
to the heart with a stethoscope.
No further tests are required for an innocent heart murmur.
If your doctor suspects the heart murmur is
pathologic, he will refer you to a pediatric
cardiologist, a doctor who specializes in treating
heart abnormalities in children.
This specialist may order an
electrocardiogram, chest x-ray, or echocardiogram
to check for abnormalities in the heart structure.
In rare cases, it may be necessary to do a cardiac
catheterization to make a complete diagnosis.
In this procedure, the doctor inserts a
thin tube (catheter) into one of the blood
vessels and into the heart.
A dye that is injected through the catheter provides a more
detailed view of the blood vessels and heart
chambers.
What
is the treatment?
Innocent murmurs do not
require treatment. If
the heart murmur is pathologic, the treatment is
often surgery.
Any treatment, however, depends upon the
symptoms and risks.
Self-care
tips
There is nothing that can be
done to prevent heart murmurs that are present at
birth.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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