Have you ever been told you have a heart murmur? Heart murmur symptoms are an unusual sound, often described as a whooshing or swishing, that occurs between the “lub… dub, lub… dub” of a normal heartbeat.
A heart murmur means something is wrong with your heart. However, it does not necessarily mean the problem is serious.
“Heart murmurs can be benign (harmless) or concerning,” says Cleveland Clinic preventive cardiologist Vikas Sunder, MD. “There are many different causes. If you have an audible heart murmur, you should see a cardiologist.”
What Is a Heart Murmur?
The heart consists of four chambers: the left and right atria, in the top of the heart; and the left and right ventricles, in the bottom. Blood flows from chamber to chamber and from the chambers to large blood vessels through valves. When the pressure between two of these structures is different, blood will rush from the area of higher pressure to the area of lower pressure. The rapid, turbulent flow produces a rushing sound that can be heard through a stethoscope and, sometimes, even with the naked ear.
Causes of Heart Murmur
Very often, heart murmurs are caused by a structural heart abnormality, such as a narrow (stenosed) or leaky (regurgitant) valve, a bicuspid aortic valve or a tear. Heart murmurs also can be caused by an abnormal connection between two chambers (shunt) or between a coronary artery and a chamber (fistula). They may even be caused by anemia (low blood iron levels) or thyroid disease.
Heart murmurs are normal in pregnancy, childhood and adolescence due to increased blood flow through the valves. Such murmurs tend to be harmless and usually resolve on their own.
“If they persist, they should be followed with echocardiography to make sure no complications arise,” Dr. Sunder says.
How Heart Murmurs Are Evaluated
A heart murmur is usually detected when a doctor is listening to the chest with a stethoscope. The sound may be unexpected.
“Sometimes you can feel the murmur if you put your hand on the patient’s chest,” Dr. Sunder explains. “There are even murmurs that you can hear with a stethoscope hovering above the skin but not touching it.”
Occasionally, individuals feel something about their heart rate is “off,” or the murmur is so loud they can hear it. “Such cases should be brought to your doctor’s attention,” Dr. Sunder advises.
When to Worry
“Everyone with a heart murmur should be evaluated by their primary care physician or cardiologist and imaging with echocardiography considered to obtain information on the pressure gradients,” Dr. Sunder says.
The cause of the murmur will determine how best to proceed. Some problems need to be surgically corrected—for example, a valve repaired or a hole in the heart sewn shut.
When the problem does not look serious, the patient may be monitored with serial echocardiograms for signs of disease progression.
