Heart Murmurs
What is It?
A heart murmur is an extra or unusual sound heard during a heartbeat, often described as a ‘whooshing’ or ‘swishing’ noise. While a normal heartbeat produces a rhythmic ‘lub-dub’ sound when the heart valves close, a murmur occurs when blood flow through the heart or nearby vessels becomes turbulent. Murmurs may be ‘innocent’ (harmless), which are common in children and during pregnancy or fever, or ‘abnormal’, which may indicate underlying heart conditions such as valve disease or congenital defects. Heart murmurs are typically detected during routine examination with a stethoscope.
What are the symptoms?
Many patients with heart murmurs have no symptoms and the murmur is found incidentally during routine examination. When abnormal murmurs cause symptoms, these may include shortness of breath (especially on exertion), fatigue, chest pain or tightness, dizziness or fainting (syncope), palpitations, and swelling of the ankles, feet or abdomen. In children, signs of a significant murmur may include poor feeding, failure to gain weight, and bluish skin.
What are the causes?
At One Heart Centre our cardiologists screen for all causes of heart murmurs. Causes include:
- Innocent (benign) causes: Increased blood flow from exercise, fever, pregnancy, or childhood growth.
- Valve problems: Stenosis (narrowing) or regurgitation (leakage) of any heart valve.
- Congenital heart defects, such as holes in the heart or abnormal valve structure.
- Other conditions: Endocarditis (infection of the heart), rheumatic fever, hypertrophic cardiomyopathy, anaemia and hyperthyroidism.
How is it investigated?
Heart murmurs are often identified on routine examination. The most important investigation is an echocardiogram to assess the valves and heart function. Additional tests may include an ECG to check for rhythm abnormalities or chamber enlargement, chest X-ray, cardiac MRI or CT scan, transoesophageal echocardiogram (TOE) for more detailed valve imaging, and cardiac catheterisation in selected cases.
What are the treatments?
At One Heart Centre our cardiologists have post-fellowship training in managing heart murmurs and will provide a personalised treatment plan for your heart murmur. Treatment depends on the cause and severity and may include:
- Surveillance: Innocent murmurs and mild abnormal murmurs are monitored with regular echocardiograms.
- Medical therapy: Medications to manage symptoms or underlying causes, including diuretics, beta-blockers, blood thinners and blood pressure medications.
- Valve repair: Surgical or catheter-based repair to preserve the native valve.
- Valve replacement: Using mechanical or biological valves, either through open surgery or minimally invasive techniques such as TAVI.