A heart murmur is the sound of turbulent blood flow in the heart usually caused by abnormal closure or opening of a heart valve or a hole in the heart.
There are 4 valves in the heart, with each having its own potential defect. In a general sense, murmurs can be caused by valvular stiffening i.e. stenosis or leaking i.e. regurgitation. Congenital anomalies such as holes in the heart or abnormal heart architecture can cause murmurs. Certain viral or bacterial infections can lead to damage to the heart and cause murmurs.
Signs and symptoms depend on the murmur, as each cause can present differently. Stenotic murmurs often present with fatigue, shortness of breath, chest pain, edema, dizziness, and palpitations can all be signs of a heart murmur. Regurgitant murmurs often present with fatigue, shortness of breath, chest pain, edema, dizziness, and palpitations. Both murmurs can be associated with dangerous heart rhythms and heart failure.
As mentioned, there are a myriad of risk factors associated with heart murmurs:
- Congenital heart defects.
- Endocarditis.
- Medications such as Fen-phen.
- Family history of heart defects.
- High blood pressure.
- Heart attacks and or heart failure.
- History of rheumatic fever.
- Certain cancers such as carcinoid.
A murmur can be detected when your doctor listens to your heart using a stethoscope during a physical exam or when an echocardiogram is performed in the office. An echocardiogram is a more sensitive and specific test for diagnosing murmurs and any murmurs auscultated by a stethoscope should be confirmed with an echocardiogram.
Treatments depend on the type and severity of the murmur. Mild to moderate murmurs are usually watched with surveillance echocardiograms and yearly stress tests. Severe murmurs often require surgical correction.
Preventive measures include avoiding diet medications like Fen-phen, treating bacterial infections properly and in a timely fashion, avoiding IV drug use and alcohol, controlling hypertension, and taking steps to avoid a heart attack. The same measures that prevent heart disease, in general, can potentially help.
- Exercise regularly.
- Eat a healthy diet.
- Quit smoking.
- Stop drinking alcohol.
- Keep pre-existing illnesses, such as high blood pressure, diabetes or high cholesterol, under control.
If left untreated, heart murmurs can put tremendous stress on the heart leading to heart failure, arrhythmias, and sudden cardiac death.
Many arrhythmias are related to heart murmurs. Mitral valve prolapse is associated with sudden cardiac death from ventricular tachycardia.
