Understanding Heart Murmurs: When Should You Worry?

Heart murmurs, abnormal sounds that become apparent during the heartbeat cycle, can leave many individuals concerned and uncertain about their implications. Addressing heart murmurs is crucial, as they can serve as potential indicators of underlying heart conditions. However, not all heart murmurs are cause for alarm.

If you’re wondering when to worry about a heart murmur, we aim to completely demystify them in this guide, exploring their types, causes, symptoms and when worry is warranted.

Types of Heart Murmurs

Heart murmurs are classified into two primary types: innocent (or benign) murmurs and pathological (abnormal or concerning) murmurs. Innocent murmurs, akin to the gentle rustling of leaves in the wind, often occur in healthy individuals, especially children. These murmurs are harmless, indicating no underlying heart conditions. Typically soft and brief, innocent murmurs are heard only during specific times, such as when a child is sitting up or lying down. They do not cause symptoms like chest pain or shortness of breath.

In contrast, pathological murmurs resonate loudly persisting throughout the cardiac cycle. These murmurs, akin to thunderstorms in the heart’s rhythm, often indicate significant heart problems. Conditions such as valve disorders (like stenosis or regurgitation), congenital heart defects (such as atrial or ventricular septal defects), infections like endocarditis or other heart conditions like cardiomyopathy can lead to these abnormal heart murmurs. 

Causes and Risk Factors

Understanding the origins of heart murmurs is pivotal in grasping their potential seriousness. Heart murmurs can stem from various underlying causes and risk factors including: 

Valve Disorders

Problems with heart valves, such as stenosis (narrowing) or regurgitation (leakage), are significant culprits behind heart murmurs. These disorders disrupt the harmony of your heartbeat, creating a distinct murmur. Specific conditions like mitral valve prolapse or aortic valve defects exemplify how these valve abnormalities can manifest, resulting in the characteristic whooshing sounds of heart murmurs. 

Congenital Heart Defects

Heart murmurs can also be a consequence of congenital heart defects, inherent abnormalities present at birth. These defects, like atrial septal defects or ventricular septal defects, create turbulent blood flow patterns, generating murmurs that clinicians recognize as innocent swishing sounds. Despite being present from birth, these defects might not always manifest symptoms immediately, making early detection crucial for timely intervention.

Infections

Infections, such as endocarditis, an inflammation of the heart’s inner lining, can wreak havoc on heart valves. As the infection progresses, it leads to inflammation and damage, causing heart murmurs. The delicate lub-dub of the heart’s rhythm transforms into abnormal murmurs, reflecting the toll infections take on the heart’s structure and function. These murmurs serve as warning signs, indicating the urgency of medical attention.

Other Heart Conditions

Beyond valve disorders and congenital defects, various heart conditions can trigger murmurs. Cardiomyopathy, a disease affecting the heart muscle and hypertrophic obstructive cardiomyopathy, a condition characterized by the thickening of the heart muscle, are notable examples. These conditions disrupt the natural flow of blood through the heart, resulting in distinct systolic and diastolic murmurs. These murmurs, although concerning, serve as signals for healthcare professionals to look more closely at the intricacies of the heart’s functioning.

Symptoms and Signs

Recognizing the symptoms and signs associated with heart murmurs is necessary for early detection and appropriate medical evaluation. These subtle yet significant indicators provide valuable clues, guiding individuals and healthcare professionals toward comprehensive assessments and timely interventions.

Chest Pain

One potential symptom of heart murmurs is chest pain or discomfort. It’s important to note that while chest pain may not always be present, its nature can vary, ranging from sharp, stabbing sensations to dull, persistent discomfort or even a squeezing feeling. This discomfort, originating from the heart’s irregular rhythms, serves as a warning sign, prompting further investigation into the heart’s health.

Shortness of Breath

Individuals with heart murmurs might experience breathlessness, especially during physical activity or while lying flat. Shortness of breath, often a result of the heart struggling to pump blood effectively, can signify underlying issues. Severe shortness of breath is particularly concerning, indicating a more serious problem warranting immediate medical attention.

Fatigue

Unexplained fatigue or excessive tiredness, even in the absence of other obvious signs, can be a symptom of heart murmurs. Persistent weariness related to heart murmurs stems from the heart’s compromised ability to circulate oxygen-rich blood efficiently.

Fainting or Dizziness

Episodes of fainting or dizziness may occur due to inadequate blood flow, especially in cases of severe valve disorders. In these instances, the heart’s inability to maintain a steady blood supply to vital organs can lead to lightheadedness and, in severe cases, fainting. These episodes serve as red flags, necessitating immediate medical evaluation to determine the root cause.

Swelling

Peripheral edema, the swelling of the legs, ankles or feet, can be a visible sign of heart murmurs caused by valve problems. This swelling occurs due to fluid retention, indicating disruptions in the heart’s pumping mechanism. Recognizing peripheral edema early on is crucial, as it often signifies advanced stages of heart murmurs, urging individuals to seek prompt medical attention.

Irregular Heartbeat

Palpitations or an irregular heartbeat (arrhythmia) can sometimes accompany heart murmurs. These palpitations, felt as abnormal fluttering or pounding sensations in the chest, are indicative of underlying structural problems within the heart. Monitoring these irregular rhythms is vital, as they can provide valuable insights into the severity of the murmurs and guide healthcare professionals in crafting appropriate treatment plans.

Not everyone with a heart murmur will experience these symptoms. Some individuals may remain asymptomatic, making regular check-ups and vigilant monitoring essential. By being aware of these potential signs and seeking medical attention when necessary, you can proactively manage your heart health, ensuring a higher quality of life and well-being.

Diagnosis

The diagnostic process for heart murmurs involves a series of steps aimed at accurate assessment. Healthcare professionals employ physical examinations, using stethoscopes to listen to heart sounds, in addition to various imaging tests like echocardiograms. These tests provide valuable insights into the heart’s structure and functioning, aiding in the precise diagnosis of the underlying cause of the murmur. Consulting a healthcare professional is pivotal for an accurate diagnosis, ensuring timely and appropriate medical attention.

When to Worry

If you experience persistent symptoms such as chest pain, shortness of breath, unexplained fatigue, dizziness or swelling, especially in adulthood, these should raise red flags. Additionally, any new onset of symptoms or the detection of a heart murmur as an adult should prompt immediate attention. Individuals diagnosed with hyperthyroidism, characterized by an overactive thyroid, need to be particularly cautious as it can lead to extra heart sounds, indicating potential issues. Unexplained weight gain coupled with symptoms like shortness of breath or palpitations should not be overlooked either. 

Treatment and Management

From lifestyle adjustments and regular monitoring under the guidance of cardiologists to the potential use of medications or in some cases, surgical interventions, the treatment spectrum for heart murmurs varies widely. Cardiologists can assess the underlying cause and severity of the murmur and develop tailored strategies that align with a patient’s health status. Regular check-ups and targeted interventions ensure that individuals can effectively manage their heart murmurs, enhancing their overall quality of life.

Final Thoughts

Not all heart murmurs are dangerous but we encourage you to speak with healthcare providers if you have any concerns or questions about them. Early detection, coupled with appropriate management, can lead to better outcomes and a healthier heart. Consult our cardiology experts at UCF Health Cardiology for comprehensive cardiovascular care and diagnostic cardiology services.