Heart Murmur

Heart murmur is a condition in which the sound of the heartbeat cycle is abnormal. This sound could be of ‘whoosh’ or ‘swish’ type, which is caused by the raging blood into or near to the patient’s heart. You would be knowing that the doctor uses a stethoscope to hear your heartbeat.

Every heartbeat of a healthy person comprises of two concurrent and clear sounds of ‘lubb-dupp’ (termed medically as ‘lub-dup’). These sounds are developed by the closing of the valves of your heart. An abnormal or unclear ‘lub-dup’ sound in the heartbeat indicates that the valves of the heart are not opening and closing expectedly.

A heart murmur could persist in an individual since birth (termed as congenital heart murmur) or is developed at a later stage during the lifetime. Around 25000 babies across the globe are born every year with heart defects causing congenital heart murmurs. Those defects may include a hole in the heart walls or an abnormal heart valve. Some of those defects are harmless, while most of the others could be treated through surgery.

It is likely that the pregnant women, kids observing rapid growth, and the individuals working out in the gym intensively may also observe heart murmurs. Note that heart murmurs themselves are not any disease. However, those could be the symptoms indicating an underlying health problem related to the heart. Many such problems may be harmless and for this, their associated heart murmurs are also called as innocent murmurs.

The patients suffering from heart murmurs do not need any treatment for its own. However, their cause could develop critical conditions at times. For instance, if those are caused due to the abnormality of the heart’s valves, it would cause a heart failure if not treated on time, which is a fatal condition. However, it is good to see a cardiologist, who may prescribe certain medical investigations for identifying the cause behind this abnormality. Based on the diagnosis, either some treatment or follow-up visits are prescribed.

Symptoms

The various symptoms associated with heart murmurs are mentioned below:

-  Dizziness or fainting

-  Breath shortness while exercising, walking briskly, climbing stairs, or lifting weight for some time

-  Turning the skin’s shade to bluish

-  Chronic cough, which is not relieved even with the treatment

-  Moderate to severe chest pain

-  Faster and observable heartbeats

-  Pain in jaws, neck, shoulders, or arms

-  Sweating up unexpectedly

-  Sudden cardiac attack

-  Fatigue feeling

-  Enlarged liver

-  Enhanced visibility of veins near to the neck

-  Loss of appetite

-  Slow growth in the case of infants

-  Swelling in multiple parts of the body

-  Rapid gain of weight

Causes

The major cause of heart murmurs in the adults is malfunctioning of heart valves. However, it is not necessary that heart murmurs are caused only because of the abnormality of the heart valves. Heart murmurs could be observed by the individuals of any age groups.

However, the people with more than 50 years of age are more likely to observe it since their heart valves tend to be weaker than the young individuals. The multiple causes of heart murmurs in the adults are mentioned below:

-  Calcification or hardening of the heart valves mainly caused in elderly individuals

-  Rheumatic fever

-  Endocarditis or bacterial infection in the inner lining of the heart spread through the bloodstream

-  Extensive workout in the gym

-  Viral fever

-  Diseases or problems during the pregnancy such as rubella infection or diabetes, which may also cause heart murmurs in the baby

-  Anaemia or inadequate Red Blood Cells (RBCs)

-  Hyperthyroidism

-  Pulmonary hypertension or high pressure of blood within the lungs

-  Intestinal cancer

-  Lupus

-  Rheumatoid arthritis

-  Family history (in blood relation) of abnormality of the heart valves

-  Usage of specific medicines or drugs

-  Overconsumption of alcohol

The causes of heart murmurs in children are mentioned below:

-  Congenital (by birth) abnormalities of the heart valves in which those do not allow sufficient flow of blood or those do not close properly

-  Rapid growth

-  Single or multiple holes in the heart’s septum, which may or may not be a serious condition

Prevention

The congenital heart murmurs could never be avoided. However, since heart murmurs in most of the cases are mainly caused by the abnormality of heart valves, you could take several precautionary measures to avoid those. For instance, following a healthy and disciplined lifestyle would limit the chances of getting heart murmurs. Some additional measures are mentioned below:

-  Exercise daily.

-  Adopt an organic diet. Eat lots of vegetables, fruits, whole grains and other plant-based food items.

-  Avoid stress. Do yoga and meditation regularly.

-  Limit the consumption of alcohol.

-  Quit smoking, as it can damage the inner surface of arteries. This would interrupt the flow of blood in the heart valves.

-  Avoid eating junk food items, as these may increase the risk of triggering the cholesterol level in the blood.

-  Take most care of your health especially if you are a patient of high blood pressure, diabetes, or high cholesterol.

-  Undergo regular health check-ups for the identification of any abnormality.

-  Discuss the findings of health check-ups with the physician and follow the recommendations very carefully.

-  Avoid unnecessary medication for minor problems.

How is it diagnosed?

Once you may observe any of the symptoms mentioned above, you first need to consult your physician. Note that the cardiologists may get an idea about the cause of heart murmur based on the loudness of the murmuring sound. They medically grade it on a scale of 1 to 6. In this scaling, 1 out of 6 or 1/6 is almost insignificant, and 6 out of 6 or 6/6 is very loud and indicates a serious threat.

The 6/6 scale heart murmur could even be heard by slightly removing the stethoscope from the chest (without touching it). The doctor may prescribe you one of the several methods through which the cause of heart murmur is diagnosed. Based on the associated additional symptoms and your past medical history, the doctor would examine and recommend one or more of the following examination for the diagnosis:

- Chest X-ray: This test would capture the X-ray images of the patient’s chest. It may help in understanding if the heart and aorta are enlarged than the usual.

- Cardiac Catheterization: In this test, a tube is inserted in the body of the patient through the groin or arm to the heart. This tube traverses through a single blood vessel, in which some material is injected, and an X-ray video is captured. This video will evaluate the functioning of the aortic valve and measure the pressure in the heart chambers.

- Echocardiogram: It is a type of ultrasound, which captures the pictures of the heart and its chambers using the sound waves. It is an extensive test for the assessment of the heart’s performance in which a device is placed above the chest of the patient. This generates video images of the heart to identify if some portion of the heart is damaged and is restricting the normal pumping of the blood.

- Electrocardiogram (ECG): This process uses an electrical device that records the operational condition of the heart by placing around 12-14 electrodes on the chest, legs and arms of the patient. In case some abnormalities are identified in the functioning of the heart or its valves, those may be causing the heart murmurs.

Treatment

Once after the diagnosis of the root cause of heart murmurs, the cardiologist may or may not prescribe some treatment to the patient based on the severity and impact of the cause. Note that the congenital heart murmurs in the children are harmless in most of the cases. Those do not need any treatment.

However, such individuals would suffer from the heart murmuring throughout their life. In case the heart murmuring is because of other reasons like high blood pressure, anaemia, or some defect in the heart valves, the doctor may prescribe one of the following medical treatment for that:

-  Angiotensin Converting Enzyme or ACE inhibitor for lowering the blood pressure

-  Anticoagulant for preventing the formation of blood clots and causing a stroke or heart attack

-  Beta blocker for lowering the pulse rate and regulating the blood pressure

-  Diuretic for removing the extra fluid and salt from the body and bringing down the blood pressure and consequently the heart murmurs

-  Statin for lowering the cholesterol level from the blood and reducing the chances of heart problems

In case the problem is severe (or 6/6 scale), and could not be treated easily with the medication, your doctor may prescribe you a surgical treatment. Some of those surgical methods are mentioned below:

- Surgery to Improvise Congenital Heart Murmur: In case the heart murmur in the children is due to some birth defect in the heart valves, a surgery to improve those defects may be carried out, if feasible. This may involve the structural repair surgery, in which the cords supporting the heart valves are shortened to the expected length.

- Open Heart Surgery: This process involves removing the narrowed heart valve and replacing it with some tissue or a mechanical valve. A mechanical valve is formed of metallic substance and is durable. However, it has the risk of developing clots in the blood and hence may need periodic replacement. A tissue valve is extracted from some freshly dead human donor, cow or pig. It does not require periodic replacement in normal cases.

- Transcatheter Aortic Valve Replacement or TAVR: In this process, the aortic valve of the patient’s heart is replaced with the prosthetic valve using an artery extracted from the leg. This is an effective method showing good results.

- Annuloplasty: This is the process of tightening the tissues near to the heart valve with the help of an artificial ring. Annuloplasty aims at closing the abnormal opening of the heart valves and reducing the heart murmurs.

- Balloon valvuloplasty: This process involves the insertion of a small catheter comprising a tiny expandable balloon in the heart valve. Once the catheter is placed at its expected position within the valve, its balloon is expanded, which widens the narrowed valve.

Complications

The heart murmurs never cause any complication on their own. However, their root cause may or may not cause complications. For instance, congenital heart murmurs due to birth defect may cause poor physical growth in the children or infants. In the adults, heart murmuring due to high blood pressure or heart valve dysfunction may cause a heart attack, heart failure, or even a stroke.

Myths

Myth #1: The only cause of heart murmurs is high cholesterol levels in the blood.

High cholesterol levels in the blood could trigger the conditions, which may result in heart murmurs. However, there are multiple other reasons because of which this problem can occur. In most of the cases, it is caused by the dysfunction of heart valves.

Myth #2: Heart murmurs are always fatal or cause complications.

It is not necessary. Heart murmurs could also occur because of multiple harmless reasons. For instance, in many cases of congenital heart murmurs, the affected individual could live a normal life without any associated complication.

Myth #3: Heart murmurs could only be treated by an open-heart surgery.

In many of the cases, heart murmurs could be treated just with the help of medications. Surgery is prescribed in some rare cases when the condition could not be improved with the medicines, or if it has fatal risks.

Myth #4: All heart murmurs need treatment.

In many cases, the causes of heart murmurs are harmless and do not need any treatment. For instance, heart murmurs in the pregnant women are normal in most of the cases and do not need medication.

Myth #5: Heart murmurs could be controlled just by adopting an organic diet and following a healthy lifestyle.

In many cases, adopting an organic diet and following a healthy lifestyle may improve the symptoms. However, you must consult your doctor for the identification of the root cause of this problem.

Myth #6: Heart murmurs are the early signs of a heart attack.

It is true that in some cases, the cause of heart murmurs may cause a heart attack. But it does not hold true in all the cases.

Last updated on : 14-09-2018

Disclaimer : Docprime doesn’t endorse or take any guarantee of the accuracy or completeness of information provided under this article and these are the views strictly of the writer. Docprime shall not be held responsible for any aspect of healthcare services administered with the information provided on this article.

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