Heart Murmurs - Causes, Symptoms, Diagnosis, Treatment
What Is Heart Murmurs?
Sometimes due to some underlying conditions there is a sound made when the heart beats. These sounds may be a normal variant or may be abnormal pointing to some problem with the heart. This is what we call as Heart Murmurs. These sounds audible to normal ears and can only be heard through a stethoscope. Heart Murmurs can be present at the time of birth or may develop much later in life but these murmurs suggest some type of problem with the heart. Normally, Heart Murmurs are harmless and do not require any specific treatment but in some cases when these murmurs are caused due to cardiac condition then treatment is required to treat the cause of the murmur.
What Causes Heart Murmurs?
As stated there are two types of murmurs, which are called innocent murmurs and abnormal murmurs. Innocent murmurs are harmless and an individual having it does not have problem with the heart. This type of murmur is quite common in infants and newborn babies. It is the abnormal murmur which is more serious as they suggest an indwelling cardiac condition. In children it is due to a genetic condition while in adults these murmurs are caused due to a heart valve defect.
Innocent Heart Murmurs: These murmurs are caused when the blood flows more quickly than the normal flow. Some of the conditions which can cause Innocent murmurs are:
- After strenuous physical exercise or workout
- At times of pregnancy
- When an individual has fever
- If an individual is suffering from anemia
- If the individual is suffering from hyperthyroidism.
These types of heart murmurs go away on their own with time but in some cases they stay for the entire life but they do not cause any health hazard.
Abnormal Heart Murmurs: These types of heart murmurs point to an underlying cardiac condition. Children have this type of murmur due to congenital heart defects like a hole in the heart or a septal defect. Some other causes of abnormal heart murmurs are calcification of the heart valves, infection of the inner part of the heart muscle also known as a condition called endocarditis. Rheumatic fever is also a cause for abnormal heart murmurs.
What Are The Risk Factors For Heart Murmurs?
Some of the risk factors for Heart Murmurs are:
- If an individual has a prior family history of heart defects then that may predispose the individual to Heart Murmurs.
- Medical conditions like hypertension, hyperthyroidism, or endocarditis can also predispose an individual to Heart Murmurs.
Some of the risk factors for Heart Murmurs in children are
- Some type of illness during pregnancy
- Taking certain classes of medications during pregnancy
- Taking alcohol or drugs during pregnancy
What Are The Symptoms Of Heart Murmurs?
In cases of Innocent Murmurs there are no specific signs or symptoms but in cases of abnormal Heart Murmurs apart from the abnormal sound which the physician can hear on the stethoscope there may be some other associated symptoms as well which are:
- Cyanotic skin especially in the fingertips and lips
- Abnormal weight gain
- Severe dyspnea
- Chronic cough
- Appetite suppression
- Chest pain
- In some cases fainting.
How Are Heart Murmurs Diagnosed?
Heart Murmurs normally can be diagnosed just auscultation of the chest, but the point here is that to diagnose whether the murmur is an innocent murmur or an abnormal murmur. This will be done by conducting some tests: for this the physician will start by considering certain factors which may be:
- How loud is the murmur?
- Where can it be heard?
- What is the pitch of the murmur?
- Does the murmur get affected by change of position?
- What is the duration of the murmur?
The physician will also inquire about the medical history to find out if there is any family history of any cardiac anomalies. In order to find out about the cause of the murmurs the physician may order the following tests:
Chest X-ray: This can reveal whether there is any enlargement of the heart or not which can rule in or rule out cardiomegaly as a cause of the heart murmur.
Electrocardiogram: This test shows the heartbeat in the form of electrical impulses. This test can show whether there is any abnormality in the rhythm of the heart and whether the heart is functioning normally.
Echocardiogram: This test makes use of ultrasound waves to look at the functioning of the heart. This test can accurately identify any abnormality of the functioning of the heart.
Cardiac Catheterization: This is a minimally invasive test in which a catheter is inserted in the heart through the leg. This test accurately measures the pressure that is exerted on the chambers of the heart.
How Are Heart Murmurs Treated?
If an individual is suffering from an innocent heart murmur then there is no specific treatment required for it since in such cases the functioning of the heart is totally normal. In case of the murmurs are caused due to benign illnesses like fever then the murmurs goes away once the fever subsides.
In case of an abnormal heart murmur in an infant or a child then again treatment may not be required and a wait and watch approach is taken and the murmurs are monitored over time. If the physician thinks that a treatment is required then the following measures are taken:
Medications: There are a variety of medications for various cardiac problems hence the physician. Some of the medications are anticoagulants like aspirin, Coumadin or Plavix. This class of medications prevents blood clots from forming which may cause a heart attack or a stroke. The next set of medications is called diuretics. These types of medications remove excess fluid from the body which may cause an abnormal heart murmur. The next set of medications is named as ACE inhibitors whose function is to lower the blood pressure. This is typically effective in hypertensive patients. Statins can also be used to control cholesterol levels and prevent Heart Murmurs. Antihypertensives like beta blockers are also helpful in controlling Heart Murmurs.
Surgery: In cases where conservative approaches are not useful in controlling murmurs then surgery may be recommended, especially in cases where there is a defect in the mitral valve. This may be done by the repairing the valve which is done by the following procedures:
Balloon Valvuloplasty: This is a procedure in which a narrowed valve is dilated or widened using an expandable balloon which is inserted in the affected area using a catheter.
Annuloplasty: This is a procedure in which the tissue is tightened around the valve after implanting an artificial ring.
Valve Replacement: This is a procedure done in which the valve is damaged beyond repair and a replacement is required. This is done by doing an open heart surgery and then implanting mechanical valve. Once an individual is implanted with a mechanical valve then he or she will have to be on anticoagulants for the rest of their lives.
How To Prevent Heart Murmurs?
There is nothing much that can be done to prevent a Heart Murmur but it is fact that most of the heart murmurs are harmless and do not cause any damage to the heart. For children this condition resolves on its own as the child grows and in adults this condition goes way once the underlying condition. For adults, once the underlying condition is treated then the individual can get rid of Heart Murmurs.