Heart Murmurs

How heart sounds help detect blood flow problems

As blood moves through your heart, sounds are created. These sounds can be heard by a health care provider when listening to your heart with a stethoscope. These heart sounds can help tell your provider if blood is flowing smoothly or if there may be areas where the blood flow is disrupted. 

What is a heart murmur?

Heart murmurs are the name for the sounds that occur when the blood flowing through your heart or nearby blood vessels is disrupted for some reason. You can’t hear a heart murmur with your ear but if your provider notices one during an exam, they will pay special attention to what it sounds like, how often it happens and how long it lasts.

Types of heart murmurs: innocent vs. abnormal

There are two types of heart murmurs, innocent (normal or physiological) murmurs and abnormal murmurs.

Innocent (physiologic) heart murmurs

Innocent murmurs are common, especially in children. They are harmless. 

They happen when blood flows quickly through the heart, and they aren’t signs of heart problems. They can sound like whooshing or swishing and may come and go. They usually clear up on their own.

Abnormal heart murmurs

Abnormal murmurs can be signs of heart issues. They are often caused by structural problems in the heart.

Abnormal murmurs may be mild or more severe. With them, you may have symptoms like shortness of breath, chest pain or fatigue. You may need testing to figure out what’s causing the murmur and to treat any health issues.

What causes heart murmurs?

Causes of innocent heart murmurs

Innocent heart murmurs can occur when blood is flowing rapidly due to:

• Growth spurts
• Physical activity
• Pregnancy
• Fever

Causes of abnormal heart murmurs

Abnormal heart murmurs can be caused by structural heart problems such as:

• Valve issues or valvular heart diseases: The heart has four valves that make sure blood flows in the right direction. If a valve is narrowed (stenosis) or leaky (regurgitation), it can create disrupted blood flow.
• Congenital heart defects: Some babies are born with structural heart defects that can affect blood flow, such as holes in the heart (septal defects) or valves that aren’t formed properly.

Babies may also be at higher risk of being born with a heart murmur if there’s a family history of heart problems, if the mother has rubella or uncontrolled diabetes during pregnancy or if the mother uses certain medications, alcohol or illicit drugs during pregnancy.

These conditions that affect blood flow may also lead to abnormal heart murmurs:

• Cardiomyopathy (weakened heart muscle)
• Heart infections such as endocarditis
• Some blood and autoimmune disorders
• Anemia
• High blood pressure in the lungs
• Calcium deposits that cause heart valve problems by making them stiff
• Hyperthyroidism (overactive thyroid)
• Rheumatic fever, a serious complication of strep throat
• Carcinoid syndrome, a rare cancerous tumor (although this is extremely rare, happening in less than 0.1% of cases)

Symptoms that may be linked to a heart murmur

Many heart murmurs are harmless and do not cause symptoms. Your health care provider may detect a murmur during a routine exam or an exam for another condition.

You should contact a health care provider if you notice these symptoms of a heart murmur in yourself or your child:

• Shortness of breath or difficulty breathing during normal activities or at rest
• Chest pain or discomfort
• Fatigue or weakness that interferes with daily activities
• Unexplained swelling in the legs, ankles or feet
• Fainting or dizziness
• Swollen neck veins
• Heavy sweating
• Sudden weight gain
• Rapid or irregular heartbeat
• Bluish tint to the skin (cyanosis), especially around the lips or fingertips
• Palpitations or a feeling that your heart is pounding
• Cough that does not go away
• Slow growth in babies

Many different health conditions could cause these symptoms. Your provider can help determine what’s causing them and recommend a treatment plan.

How are heart murmurs diagnosed?

As part of a physical exam, your provider will listen to the murmur and determine:

• How it sounds (loud, quiet, high or low pitched) – each type of sound can often be connected to a specific part of the heart   
• Where it’s located
• If the sound changes when you move
• If it happens when your heart is filling with blood, emptying or throughout the heartbeat

Your provider may also check your blood pressure, blood oxygen level and pulse.

They may recommend diagnostic tests to evaluate a heart murmur and the heart’s rhythm, movement, strength and structure. Heart murmurs may be diagnosed with tests such as:

• Echocardiogram: This ultrasound test uses sound waves to create images of the heart's structure and function. Your provider can use it to see the heart’s valves, chambers and blood flow.
• Chest X-ray: A chest X-ray can help determine the size and shape of the heart and look for any fluid buildup in the lungs. 
• Electrocardiogram (EKG or ECG): An EKG records the electrical activity of the heart. It helps spot irregular heart rhythms and can uncover structural problems.
• Stress test: In some cases, your provider may recommend a stress test to check your heart function during physical activity.
• Holter monitor: You can wear this portable device to record your heart's electrical activity over 24 to 48 hours. It can help spot irregular heart rhythms that only happen once in a while.

If you or your child has a heart murmur, it’s important to follow up with testing and get an accurate diagnosis. That way, you can find out if it’s caused by a heart problem, make the best treatment decisions and possibly avoid complications.

Treatment options for heart murmurs

Treating heart murmurs depends on the type of murmur and what’s causing it.

For innocent murmurs

Innocent murmurs are usually harmless and often do not need to be treated. Your provider may check the murmur regularly and possibly recommend echocardiograms.

For abnormal murmurs

Abnormal heart murmurs may be treated by medications to manage symptoms or address certain heart conditions:

• Medication to reduce fluid buildup like diuretics.
• Blood pressure medications like beta blockers and angiotensin-converting enzyme (ACE) inhibitors to help manage high blood pressure, which may affect heart function
• Blood thinners to help prevent blood clots
• Medications to treat certain issues, like anemia or thyroid conditions

Surgery can correct structural heart problems. A valve repair or replacement can correct issues with leaky or narrowed valves. Holes in the heart wall that are present at birth (septal holes) can be closed to restore normal blood flow.

Depending on the heart condition being treated, surgery may be done as a catheter procedure (using thin tubes), minimally invasive surgery, robotic surgery or open-heart surgery.

You and your provider can work together to decide on the best treatment plan, based on what’s causing your heart murmur, your age and overall health.

Why choose Banner Health for heart murmur care?

When it comes to heart health, choosing the right provider matters. Banner Health offers:

• Advanced diagnostic tools that deliver precise imaging of your heart’s structure and blood flow
• Expert providers including cardiologists, nurses and care teams experienced in diagnosing and treating all types of heart murmurs
• Patient education and support to help you understand your diagnosis, treatment plan and lifestyle changes that support heart health

When to see a doctor for a heart murmur

Heart murmurs are sounds made by blood moving in and around your heart. Some are harmless, but others may point to heart problems.

If you or your child has symptoms like shortness of breath, chest pain or fatigue, talk to an expert at Banner Health. Early diagnosis and treatment can help prevent complications.