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Does a Heart Murmur Always Mean There’s a Problem with the Heart?

Does a Heart Murmur Always Mean There’s a Problem with the Heart?

Nov 10, 2024 | 0 comments posted by Nature Target

During routine check-ups or doctor visits, stethoscopes are commonly used to listen to heart sounds. When informed of a heart murmur, many people may feel anxious and start to worry: What causes a heart murmur? Does it mean there’s a problem with the heart? What tests are necessary? Is surgery needed? A series of questions can start to surface. Before becoming too concerned, it’s essential to understand what a heart murmur is.

What is a Heart Murmur?

When the heart contracts and relaxes, the valves inside open and close, accompanied by the sound of blood moving against the vessel walls, which generates the heartbeat. Generally, in one cycle of a heartbeat, we only hear the “lub-dub” of normal heart sounds—“lub” signifies the heart contracting and blood moving from the heart to the arteries, while “dub” indicates the heart relaxing and blood flowing in from the veins. If, during this process, additional abnormal sounds accompany the heartbeat, this is known as a “heart murmur.”

A Heart Murmur Doesn’t Necessarily Mean Heart Disease

Heart murmurs can be categorized into benign murmurs (also known as innocent or functional murmurs) and abnormal murmurs (also known as structural or pathological murmurs).

Benign murmurs are common in children and adolescents. In these cases, the heart's structure and function are normal, with only a faint murmur present. This typically does not require activity restrictions or special treatment and often disappears as the child ages. Additionally, about 10% of adults experience functional murmurs, especially when their heart rate increases, as blood flows faster through the heart, making the murmur more noticeable. This often occurs after exercise or during states of anxiety, fever, or severe anemia.

On the other hand, structural murmurs are caused by underlying heart abnormalities. Approximately 1% of infants are born with murmurs due to congenital heart issues, such as abnormal openings between the heart chambers or malformed heart valves. For adults, most structural murmurs arise from heart valve dysfunction, and different conditions produce distinct murmur sounds.

For instance, the heart can be thought of as a house. When issues occur, such as a door that doesn’t close tightly (valve insufficiency), a door that only opens partially (valve stenosis), or a hole in a wall (septal defect), wind blowing through the structure would create abnormal sounds like “whooshing,” “hissing,” or “creaking.”

What Tests Are Needed When a Heart Murmur is Found?

If a heart murmur is detected, try not to become overly anxious, but don’t ignore it either. The first step is to determine whether the murmur is benign or abnormal. After detecting a murmur, healthcare providers will assess its type through medical history and a physical exam.

For benign murmurs, no special intervention is typically needed—rest, balanced nutrition, and regular follow-ups are often sufficient. If the murmur might be abnormal or is uncertain, further testing will be needed to clarify the cause, allowing doctors to accurately assess the condition. The doctor may recommend the following tests:

Electrocardiogram (ECG): Evaluates the heart’s electrical activity.
Echocardiogram: Shows the size of the heart chambers, assesses blood-pumping function, observes heart valves, and checks for structural abnormalities.
Chest X-ray: Examines the size and shape of the heart.

Based on the combined test results, the doctor will offer further guidance. If an abnormal murmur is found, it often indicates a structural heart issue, and appropriate treatment, possibly including surgery, may be required based on severity.

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