Updated January 12, 2021
You’re familiar with the part in your annual physical when your doctor listens to the steady thrum of your heartbeat through a stethoscope. Your doctor is making sure your heart’s beats per minute, or BPM, is within a normal range.
Your pulse tells a lot about what’s going on behind the scenes in your body and heart. A change in pulse can indicate a heart murmur or heart disease. If you have a heart murmur, your doctor may notice an extra sound as blood flows through your body.
These heart murmurs sound scary, especially in the case of small children. But they’re far more common than you may realize.
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What Is a Heart Murmur?
It’s important to know what a heart murmur is and what it feels like. A typical heart murmur sounds like a whooshing noise. According to the American Heart Association, it usually feels like a very subtle extra pulse.
Heart murmurs are common, especially among young children. They are usually normal and are called innocent heart murmurs. Research shows that nearly half of all children have innocent heart murmurs that disappear as they grow.
Adults can also have innocent heart murmurs, typically when they’re 50 or older. Sometimes, heart murmurs can occur when you’re feeling under the weather, running a fever, or are pregnant.
Most heart murmurs are normal and may run in your family. However, abnormal heart murmurs are signs of a more serious problem like heart disease. Abnormal murmurs often come with other symptoms.
Types of heart murmurs
There are several different types of heart murmurs. During an exam, a doctor will analyze murmurs for factors like pitch, loudness, frequency, duration, and location. That information helps to determine the type and severity of the murmur.
Murmurs are graded on a scale of one to six, which measures how loud the murmur sounds when listened to through a stethoscope. A murmur with a grade of one can barely be heard.
The three main types of murmurs are:
- Systolic murmurs: A systolic murmur occurs as the heart contracts, when it fills up with blood.
- Diastolic murmurs: A diastolic murmur happens in between heartbeats, when the heart relaxes and releases blood.
- Continuous murmur: A continuous murmur is one that begins when the heart is contracting and continues unstopped until at least part of the way through diastole, when the heart is relaxing.
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What Causes Heart Murmurs?
Children and adults can experience heart murmurs for different reasons.
- Heart defect: Often the cause of a murmur can be linked to a heart defect at birth, according to the American Heart Association. Examples of congenital heart defects are septal defects, also known as holes in the heart, or patent ductus arteriosus, when blood flows abnormally through an open channel between the aorta and the pulmonary artery, bypassing the lungs. Many times, heart murmurs present at birth eventually go away.
- Defective heart valve: These murmurs can occur with tight or leaky valves. If a heart valve is tight, the opening is smaller than normal, which can cause problems with blood flow. Leaky valves don’t close correctly, causing blood to flow in the wrong direction when the valve should be closed.
- Health conditions: Murmurs that occur later in life can indicate other health conditions, including fever, overactive thyroid glands, anemia, and pregnancy. If you’ve experienced heart problems in the past and your heart is scarred or you suffer from damaged valves, these conditions also can cause a murmur.
- Asymmetric septal hypertrophy: If a heart muscle is too big or too thick, it can prevent blood flow.
- Cardiac myxoma: This is a rare, non-cancerous tumor that can grow inside your heart, partially obstructing blood flow.
Doctors will listen to heart murmurs through a stethoscope. They may run more tests to determine the cause of the murmur and whether it’s innocent or potentially dangerous.
Heart Murmur Treatment
Doctors typically detect murmurs during a routine exam and can determine if the murmur is serious. Your doctor will ask if you’re having symptoms related to your heart, like shortness of breath, feeling faint, or a fluid buildup in your legs and lungs.
If your murmur seems serious, your doctor may send you to a cardiologist. These specialists can decide what treatment options are best and whether you need more testing.
Although the heart murmur itself may not need treatment, doctors may need to correct the underlying problem causing the murmur.
- Medication: Doctors may describe different types of medicines depending on the type of murmur you have. Examples include angiotensin-converting enzyme (ACE) inhibitors, antibiotics, beta-blockers, or diuretics.
- Surgery: Many heart problems, including congenital defects, damaged valves, and cardiac myxomas, require surgery for repair.
Innocent heart murmurs don’t usually need treatment, but abnormal murmurs may require medicine or surgery.
You should see a doctor if you begin to experience symptoms like shortness of breath, dizziness or lightheadedness, chest pain, or irregular or rapid heartbeat.
If you’re concerned about a heart murmur or would like to know more about what causes heart murmurs, contact the UPMC Heart and Vascular Institute to schedule an appointment.
The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine.