A heart murmur is an extra or unusual sound heard during a heartbeat. These sounds are made by turbulent blood flow in the heart. Think of it like listening to water flowing smoothly through a pipe versus water rushing through a narrow section – the rushing water makes more noise. Heart murmurs aren’t diseases themselves, but rather sounds that can indicate whether the heart is working normally or if there might be an underlying issue.
Heart murmurs can be categorized as innocent or worrisome. Innocent heart murmurs are common, especially in children, and are not a sign of a heart problem. They are often due to normal blood flow dynamics. Worrisome heart murmurs, on the other hand, can signal structural issues within the heart.
In children, when a heart murmur raises concern, it’s often linked to congenital heart defects. These are problems with the heart’s structure that are present from birth. Some congenital causes of worrisome heart murmurs include:
- Holes in the Heart: These holes can develop in the walls separating the heart chambers. Examples include an atrial septal defect, a hole between the upper chambers, or a ventricular septal defect, a hole between the lower chambers. These holes can cause blood to flow abnormally, creating a murmur.
- Cardiac Shunts: These are also congenital heart defects that cause blood to flow in irregular patterns between the heart’s chambers or major blood vessels. This unusual blood flow can be noisy and result in a heart murmur.
While congenital heart defects are the primary concern for worrisome murmurs in children, in adults, these sounds are more frequently associated with acquired heart valve disease. This means the valve problems develop over time. Conditions that can lead to worrisome heart murmurs in adults include:
- Calcium Deposits: As we age, calcium can build up on heart valves, like the mitral valve or aortic valve. This buildup can cause the valves to stiffen and narrow, a condition called valve stenosis. Calcification can also prevent valves from closing properly, leading to blood leaking backward. Both scenarios create turbulent blood flow and murmurs. This is often termed calcific or degenerative valve disease.
- Infection of the Inner Heart Lining and Valves (Endocarditis): Bacteria or other germs can cause this serious infection. These germs can travel through the bloodstream from another part of the body to the heart. If endocarditis affects the heart valves and is left untreated, it can cause a new heart murmur or worsen an existing one.
- Rheumatic Fever: This is a complication of untreated strep throat, though it’s rare in many developed countries today. Rheumatic fever can damage heart valves, leading to rheumatic heart disease. The damaged valves can then cause heart murmurs due to improper blood flow.
It’s important to note that the presence of a heart murmur doesn’t automatically mean there is a serious problem. However, any heart murmur, especially if newly detected in adults or accompanied by other symptoms, should be evaluated by a healthcare professional to determine its cause and whether any treatment is needed.
