Heart Murmurs – Symptoms and Causes
Overview
Heart murmurs are unusual sounds made when blood flows turbulently through the heart. These sounds, often described as whooshing or swishing, can be heard through a stethoscope.
Normally, a healthy heartbeat creates two distinct sounds—”lubb-dupp”—when heart valves close.
There are two main types of heart murmurs:
- Congenital: Present at birth.
- Acquired: Develop later in life.
Not all heart murmurs indicate a problem. Innocent heart murmurs require no treatment and don’t signal heart disease. However, other heart murmurs may point to serious heart conditions that need medical attention.
When doctors detect a concerning heart murmur, they typically order tests to examine the heart and valves more closely. The treatment approach depends entirely on what’s causing the murmur.
Symptoms
Harmless heart murmurs typically cause no symptoms. However, concerning heart murmurs may produce various signs based on their underlying cause.
People with problematic heart murmurs might experience:
- Blue or gray coloration in fingernails or lips
- Pain in the chest area
- Persistent cough
- Feeling lightheaded or dizzy
- Enlarged liver
- Swollen veins in the neck
- Fainting episodes
- Excessive sweating without physical activity
- Poor feeding and growth problems in babies
- Difficulty breathing
- Unexplained swelling or rapid weight gain
When to See a Doctor
Most heart murmurs are not dangerous. However, if you have concerns about a heart murmur, schedule an appointment with your primary care doctor.
They can examine you and determine if you need to see a specialist or have additional tests.
Why Heart Murmurs Happen
Harmless Heart Sounds
Innocent heart murmurs come from fast-moving blood that creates sounds but doesn’t signal a heart problem. These murmurs are especially common in babies and young children.
Several factors can trigger these harmless sounds:
- High body temperature during illness
- Anemia (low red blood cell count)
- Overactive thyroid gland
- Growth spurts, particularly during teen years
- Physical activity or exercise
- Pregnancy
Many innocent murmurs disappear as children grow. Some people have these harmless sounds throughout life without any health issues.
Concerning Heart Sounds
In children, concerning murmurs typically result from heart structure problems present at birth. These include:
- Heart wall openings: Holes may form between the upper chambers (atrial septal defect) or lower chambers (ventricular septal defect).
- Abnormal blood pathways: Blood may flow irregularly between heart chambers or blood vessels due to structural problems.
For adults, concerning murmurs usually develop from valve problems that appear later in life:
| Cause | What Happens | Result |
|---|---|---|
| Calcium Buildup | Valves become stiff or don’t close properly | Blood flows abnormally, creating sounds |
| Heart Infection | Bacteria damage heart lining and valves | Valve function changes, creating murmurs |
| Rheumatic Fever | Untreated strep throat leads to valve damage | Altered blood flow creates unusual sounds |
When calcium affects heart valves (called calcific valve disease), it can make them narrow (stenosis) or prevent them from closing completely. Both problems change how blood moves through the heart.
Heart infections start when germs travel through the bloodstream from another body part, like the mouth. Without treatment, these infections can damage valves and create murmurs.
Rheumatic fever, a rare but serious complication of strep throat, can harm heart valves permanently. When this happens, doctors call it rheumatic heart disease, which often causes noticeable murmurs during examination.
Risk Factors
Several factors can raise the chance of developing heart murmurs. In babies, risks include:
- Family history of heart problems
- Mother’s uncontrolled diabetes during pregnancy
- Exposure to rubella (German measles) during pregnancy
- Mother’s use of certain medications, alcohol, or drugs while pregnant
For people of all ages, certain medical conditions can increase heart murmur risk:
| Medical Condition | Connection to Heart Murmurs |
|---|---|
| Carcinoid Syndrome | Rare tumor releasing chemicals into bloodstream |
| Cardiomyopathy | Weakened heart muscle |
| Endocarditis | Infection of the heart lining |
| Anemia | Low red blood cell count |
| Hypereosinophilic Syndrome | Blood disorder with high white cell counts |
| Autoimmune Disorders | Including lupus and rheumatoid arthritis |
| Heart Valve Disease | Problems with heart valves |
| Pulmonary Hypertension | High blood pressure in lung vessels |
| Rheumatic Fever History | Past infection affecting the heart |
| Hyperthyroidism | Overactive thyroid gland |
Prevention
There’s no specific way to prevent heart murmurs. However, adults can make healthy lifestyle changes to improve overall heart health and reduce risks of conditions that cause murmurs.
These include:
- Eating a balanced diet
- Regular exercise
- Avoiding smoking
- Managing stress
Many heart murmurs in children resolve naturally as they grow and develop, requiring no treatment or prevention measures.
