Heart Murmur Symptoms: Important Warning Signs

Heart murmurs, the unusual sounds heard during a heartbeat, can often be a sign of numerous cardiac conditions, ranging from mild to severe. Understanding these signs and their implications is a crucial aspect of cardiac health awareness. Here, we take a closer look at the symptoms of heart murmurs, their causes, diagnosis, and treatments, so that you can identify the warning signs and improve your heart health.

In this article you will learn:

• What is a Heart Murmur?
• Heart Murmur Symptoms
• Heart Murmur Causes: Underlying Factors and Associated Risks
• Heart Murmur Diagnosis
• Heart Murmur Treatment

Heart murmurs are sounds made by turbulent blood flow within the heart, often described as a whooshing or swishing noise that is heard alongside the heartbeat during a heart examination (1). Studies suggest that heart murmurs are detected in approximately 10% of adults and 30% of children (ages 3-7) up to, with most being innocent murmurs that do not signify heart problems (2). However, in adults, the prevalence of heart murmurs increases with age, particularly due to valvular heart disease. While heart murmurs can occur in adults without heart disease and have no serious implications, they can also indicate various underlying cardiac conditions that may require further medical investigation (3). The two types of murmurs are:

• Innocent Murmurs: These are typically found in children and are harmless. They can be due to physiological conditions such as pregnancy or rapid growth and usually do not require treatment (3).
• Abnormal Murmurs: May indicate issues such as valvular heart defects, requiring further evaluation and management (3).

The symptoms of heart murmurs can be subtle and may often be mistaken for normal variations in bodily functions. It is important to understand these symptoms as they may be the first indicators of underlying heart issues, as they may include (4):

• Tiredness
• Shortness of breath
• Chest pain
• Fainting or dizziness
• Decreased exercise tolerance
• Swelling in legs, arms or abdomen
• Cyanosis – bluish colouration of the skin, lips and fingernails
• Increased sweating while resting or while doing minimal activity

Seek medical attention if you experience these signs of a heart murmur.

Understanding the causes of heart murmurs involves delving into the various heart conditions and external factors that can influence the flow of blood through the heart. A heart murmur itself isn’t a disease but rather a symptom of an underlying condition that may be affecting the heart’s structure or function. Murmurs may be due to (4,5)

• Congenital Heart Defects: Congenital heart defects are structural problems with the heart that are present at birth. These can include issues such as holes in the heart (like atrial or ventricular septal defects), problems with valves (such as stenosis or regurgitation), and abnormalities in heart walls or chambers.
• Valvular Heart Disease: Conditions that affect the heart valves, such as mitral valve prolapse, aortic valve stenosis, or rheumatic heart disease, can cause turbulent blood flow, leading to murmurs
• Cardiomyopathies: Diseases of the heart muscle, like hypertrophic cardiomyopathy, can change the way blood flows through the heart, resulting in murmurs.
• Endocarditis: An infection of the inner lining of the heart chambers and heart valves (endocarditis) can damage or weaken valves, leading to a murmur..
• Rheumatic Fever: This inflammatory disease can develop after a streptococcal infection and may cause heart valve damage, contributing to the development of a heart murmur.
• Pregnancy: Increased blood volume during pregnancy can lead to increased blood flow through the heart, which may sometimes cause a benign heart murmur..
• High Blood Pressure (Hypertension): Chronic hypertension can lead to the thickening of the heart muscle, altering blood flow and potentially causing a murmur..
• Thyroid Disorders: Both hyperthyroidism and hypothyroidism can impact heart function and may be associated with heart murmurs
• Aging: Degenerative changes in the heart structure as part of the aging process, such as calcification of the valves, can lead to murmurs.
• Risk Factors: Several factors can increase the risk of developing a heart murmur. These include a family history of heart defects, high blood pressure, high cholesterol, diabetes, and lifestyle factors such as smoking, excessive alcohol use, and lack of exercise.

It’s important to note that not all heart murmurs are symptomatic, and not all are indicative of cardiac disease. Some murmurs are discovered incidentally during a physical exam and may not affect your health or quality of life. However, when murmurs are associated with symptoms or significant risk factors, they warrant a comprehensive cardiac evaluation to determine the underlying cause and appropriate treatment.

Listening to the heart with a stethoscope is the primary method for detecting heart murmurs, but it is the start of a diagnostic journey that may include various tests to assess the heart’s function and structure. These may include:

• Stethoscope Examination: The first step in identifying a heart murmur is careful listening for any unusual heart sounds (6).
• Diagnostic Imaging: Tools such as echocardiograms (ECG) provide detailed images of the heart, helping to determine the cause and severity of the murmur (7)
• Cardiac Catheterisation: In complex cases, this invasive procedure allows doctors to measure pressures inside the heart and examine the heart valves and chambers directly.

However, echocardiography is most commonly used and the gold standard for assessing heart murmurs (8).

The treatment for heart murmurs varies greatly depending on the underlying cause. However, treatment will usually involve (9):

• Monitoring: Regular medical check-ups can help keep track of innocent murmurs and ensure that it is not indicative of progressing heart disease
• Medication: In more serious cases, medications may be used to control symptoms or treat the underlying heart condition causing the murmur.
• Surgery: Surgical options, such as valve repair or replacement, may be necessary for those with severe valve abnormalities or congenital heart defects.

Heart murmurs can be a complex condition to understand, but with proper knowledge and attention to symptoms, they can be appropriately managed. Follow up with a healthcare professional for support if you experience symptoms or have been diagnosed with a heart murmur.