A heart murmur is an extra sound heard during a heartbeat. It can sound like a whooshing or swishing noise. While many heart murmurs are harmless, some can indicate an underlying heart problem. This article explores the causes and concerns associated with heart murmurs.
In children, worrisome heart murmurs are often linked to structural issues present at birth, known as congenital heart defects. These defects disrupt the normal flow of blood through the heart, creating the murmur.
Congenital heart defects that can cause concerning heart murmurs include:
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Holes in the heart: These holes can form in the wall (septum) separating the upper (atria) or lower (ventricles) chambers of the heart, or both. Common examples include atrial septal defect (ASD) and ventricular septal defect (VSD). The abnormal flow of blood through these holes can be heard as a murmur.
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Cardiac shunts: This refers to a congenital heart defect that causes abnormal blood flow between the heart chambers or blood vessels. The irregular flow patterns produce characteristic murmurs.
In adults, concerning heart murmurs are more frequently due to heart valve problems that develop later in life, termed acquired heart valve disease. These valve issues disrupt the smooth and efficient flow of blood through the heart.
Factors that can damage the heart valves and lead to worrisome murmurs include:
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Calcium deposits: Calcium can accumulate on heart valves, such as the mitral or aortic valve, causing them to stiffen and narrow. This condition is known as valve stenosis. Calcification can also prevent a valve from closing completely, resulting in blood flowing backward (regurgitation). The altered blood flow caused by these changes generates a murmur. This process is generally referred to as calcific or degenerative valve disease.
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Infection of the inner heart lining and valves (endocarditis): This infection is caused by bacteria or other germs that travel through the bloodstream to the heart from another part of the body, such as the mouth. If left untreated, endocarditis can damage the heart valves and cause a murmur.
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Rheumatic fever: This is a serious complication of strep throat, although it’s rare in developed countries like the United States due to widespread antibiotic use. Rheumatic fever can occur when strep throat is not treated or treatment is not completed. When rheumatic fever affects the heart valves, it is called rheumatic heart disease. The resulting valve damage can lead to a heart murmur.
A heart murmur itself isn’t a disease, but it can be a sign of an underlying heart condition. If a concerning heart murmur is detected, further evaluation is needed to determine the cause and severity. This might include an echocardiogram or other diagnostic tests. Early diagnosis and management of the underlying heart condition can help prevent complications and improve overall heart health.
