A heart murmur is the sound the blood makes as it moves through the heart or blood vessel. It’s what your pediatrician hears when their stethoscope is on your child’s chest. A heart murmur isn’t necessarily bad. In fact, the majority of heart murmurs are classified as innocent — they are simply the result of blood flowing normally. Think of it like listening to water flowing through a garden hose. When the faucet is turned on, the water makes a sound as it moves through the hose. You can tell by that sound that everything is flowing normally, just like the sound of an innocent murmur. If there is a kink in the hose, however, the sound is different. The change in sound alerts your physician that there may be something wrong.
Innocent vs. Pathologic
The majority of heart murmurs are innocent — they come and go without any cause for alarm. Pathologic murmurs are different. These are often louder and may have other sounds associated with them. They can occur at specific times in the cardiac cycle or in certain locations on the chest. Extra sounds like clicks sometimes may be associated with an abnormal valve. There can be third and fourth heartbeats (called a gallop) or a friction rub. All of these sounds give the doctor clues as to what may be causing them.
While a pathologic murmur may be associated with a valve that is becoming narrower or is leaky, it also could be an indication of a problem such as holes in the heart, abnormalities of blood vessel connections, narrow blood vessels or problems with the heart muscle itself.
Get Checked Out
If an innocent murmur is suspected or discovered, your pediatrician will reassure you that there is nothing to worry about. If your doctor thinks the murmur may be more concerning (pathologic), they will recommend your child have further testing such as an electrocardiogram or an echocardiogram (or echo), which essentially is an ultrasound of your heart. This may include referral to a pediatric cardiologist for an expert opinion and perhaps further testing.
From there, possibilities can go in many different directions depending on what is discovered. Recommendations could range from observing for changes over time to actually requiring surgical intervention.
Innocent murmurs often will come and go (and are particularly common in our younger patients), but as we grow older, our chest wall gets thicker. This makes murmurs harder to hear, and often for this reason people may think they had a heart murmur but “grew out of it.”
My recommendation is this: Be certain to visit your pediatrician for well-child visits and checkups. If you’re related to someone who may have had a heart murmur in the past, it is very likely that it was innocent and that alone is not a reason to need special testing.
Murmurs are very common in children and young adults. If your child is referred for a closer evaluation of a murmur, there is no reason to panic. But it is important to get it checked out.
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