Heart murmurs:
Symptoms, types, causes, diagnosis, treatment and prevention

What is a heart murmur?

The heart pumps blood into the blood vessels with every beat. The flow of blood due to this pumping creates a sound like whooshing or swishing, known as heart murmurs. These sounds can be heard by your doctor with a stethoscope. The closure or opening of the valves in each heart beat creates the sound “lubb-dupp”.

What are the types of heart murmurs?

Sometimes, heart murmurs may be present at birth, called congenital murmurs, or even develop at a later stage in life. Heart murmurs are broadly of two types:

Harmless/innocent: Many of the heart murmurs may not need treatment. These are called harmless/innocent murmurs. These can occur as a result of rapid blood flow through the heart in certain situations like:

• Anaemia
• Fever
• Hyperthyroidism
• Physical activity or exercise
• Pregnancy

Innocent heart murmurs may either disappear with time or can last longer without any health issues.

Abnormal heart murmurs: These murmurs may be an indication of underlying heart problem and may require treatment by a cardiologist.

What are the symptoms associated with heart murmurs?

Some of the following signs or symptoms, may be associated with an underlying disease causing heart murmurs:

• Bluish colour of skin of lips or fingertips
• Chest pain
• Dizziness or fainting
• Increased tendency to sweat
• Long standing cough
• Prominent neck veins
• Shortness of breath
• Slow growth in children
• Swelling or sudden weight gain

What are the causes for abnormal heart murmurs?

Abnormal murmurs can be seen in babies, children or adults.

Causes for abnormal heart murmurs in babies are:

Any kind of structural defect or congenital heart defect like:

• Septal defects: Holes in the heart or cardiac shunts. Depending on the size of the hole and its location, the resultant heart murmurs may or may not be serious.
• Defects in heart valves: Abnormality associated with inadequate bloodflow through the valve i.e narrowing of the valve (stenosis) or improper closure leading to leakage or back flow (regurgitation).

Causes for abnormal heart murmurs in children and adults include:

Infections or conditions leading to damage of heart structure like:

• Valve calcification: Mitral stenosis, aortic valve stenosis
• Endocarditis: Caused due to bacterial infection within the heart tissues and valves
• Rheumatic fever: Caused due to a throat infection, specifically caused by Streptococcus,further affecting the heart valves.

What are the risk factors of heart murmurs?

Some conditions increase the chances of developing a heart murmur like:

• Family history of a heart defect
• Certain medical conditions like high blood pressure, endocarditis, damage to heart muscles etc
• Illnesses during pregnancy like diabetes or a rubella infection
• Certain medicationsthat are contraindicated during pregnancy
• Heavy alcohol consumptionleading to alcoholic cardiomyopathy

How are heart murmurs diagnosed?

Heart murmurs can be diagnosed by a cardiologist with:

• Medical history
• Physical examination and auscultation with stethoscope
• Testsif cardiologist suspects the murmurs to be abnormal
  • Chest X-ray
  • Electrocardiogram (ECG)
  • Echocardiogram
  • Cardiac catheterization: To measure the pressure in heart chambers
  • Blood tests
  • Doppler echocardiography

What is the treatment for abnormal heart murmurs?

Some types of abnormal heart murmurs may just require monitoring by the cardiologist over time. Treatment generally depends on the nature of underlying problem and includes:

Medication:Based on the condition, the doctor may prescribe medicines to treat the underlying cause.
Surgery:

• Valve repair
  • – Balloon valvuloplasty
  • – Annuloplasty
  • – Repair of valvular structural support
  • – Valve leaflet repair
• Valve replacement
  • – Open-heart surgery and replacement of natural valve with a mechanical valve or a tissue valve
  • – Transcatheter aortic valve replacement (TAVR)
• Maze procedure
  • – Maze procedure may concurrently be performed with surgery of the valve
  • – Cardiac surgeon creates incisions in the atria to create scar tissue which interferes with stray electrical impulses that cause atrial fibrillation.

Heart surgery recovery and rehabilitation:

The kind of heart disease and the type of surgery governs the recovery time. It usually takes 6-12 months to recover fully and resume a normal lifestyle. Your healthcare team shall advice you on:

• Care of the incision site
• Identifying signs of infection
• Cardiac rehabilitation exercises and physiotherapy
• Follow up appointments
• Medicines
• Emergency advice
• Lifestyle changes like quitting smoking, diet management, physical activity and stress management

How can abnormal murmurs be prevented?

Even though medicines may not cure heart valve disease and surgery may be required for treatment of some kind of murmurs, lifestyle changes for heart health can help in delaying complications. Some of these changes include:

• Eat healthy and nutritious food
• Do regular exercise
• If you do, stop smoking and excess alcohol
• Maintain a healthy weight
• Control your blood pressure and cholesterol levels
• Maintain follow-up care with your cardiologist

How to choose the best cardiologist for abnormal heart murmurs? What affects the cost of treatment?

For treatment of heart murmurs, one should select a hospital with the availability of an experienced cardiologist or pediatric cardiologist for kids, cardiothoracic surgeon and infrastructure support like cath lab, advanced OT, cardiac care ICUs and lab support.

Cost of treatment may depend on factors like:

• Type of underlying disease and treatment, overall health of the patient
• Technical expertise and infrastructure requirements
• Corrective surgeries, cost of consumables like valves, medications etc
• Length of stay in the hospital
• Tests required

To know more about heart murmurs, you can request for a call back and our Heart Murmur specialist will call you and answer all your queries.

Our related blogs on heart murmurs and heart diseases:

• 5 Major Heart Diseases, Causes, Symptoms and Risk factors
• A chronic heart condition caused by rheumatic fever that can be prevented and controlled
• Arrhythmia, the common heart disease
• Hypertensive Heart Disease or High blood pressure

References:

• Mayo Clinic. Heart Murmurs. Available at: https://www.mayoclinic.org/diseases-conditions/heart-murmurs/symptoms-causes/syc-20373171 Accessed on March 05, 2018.
• National Heart, Lung and Blood Institute. Heart Murmur. Available at: https://www.nhlbi.nih.gov/health-topics/heart-murmur Accessed on March 05, 2018.
• American Heart Association. Heart Murmur. Available at:https://www.heart.org/HEARTORG/Conditions/More/CardiovascularConditionsofChildhood/Heart-Murmurs_UCM_314208_Article.jsp Accessed on Accessed on March 05, 2018.

Disclaimer:

“The content of this publication has been developed by a third party content providerwho are clinicians and/or medical writers and/or experts. The information contained herein is for educational purpose only and we request you to please consult a Registered Medical Practitioner or Doctor before deciding the appropriate diagnosis and treatment plan.”