Heart Murmurs

The sounds that blood flowing makes is given a blanket name, “murmur”. These whooshing or swishing sounds made by flowing blood near the heart are heard during the heartbeat cycle. You can hear these sounds using a stethoscope.

It is normal for babies to have heart murmurs (47). Alternatively, it can develop in adulthood. However, it is not a disease, but it is the tip of the iceberg of a more potent and underlying heart condition.

Types of murmurs: These include:

  • Systolic murmur: This happens when there’s a muscle contraction of the heart. These murmurs are divided into two: ejection murmurs (where blood flows through a narrow vessel) and regurgitant murmurs.
  • Diastolic murmur: This occurs when the heart muscle relaxes between two beats. These murmurs happen when the mitral or tricuspid valves, narrow down or there is a regurgitation of the pulmonary or aortic valves.
  • Continuous murmur: This happens continuously through the cardiac cycle.

Symptoms: Usually, people diagnosed with heart murmurs do not experience any symptoms. Yet, murmurs can occur along with the following symptoms:

  • Bluish skin or on the fingertips
  • Chest pain
  • Heart palpitations
  • Physical exhaustion
  • Shortness of breath
  • Sudden weight gain
  • Enlarged veins in the neck
  • Enlarged liver
  • Chronic cough
  • Lack of appetite
  • Heavy perspiration
  • Fainting

Causes of heart murmurs:

Valvular heart disease: This is the commonest cause of a heart murmur.
Valve stenosis: This involves tightness, stiffening and narrowing of the valve, thereby reducing blood flow.
Valve regurgitation: Here, the valve doesn’t close entirely, but recedes to flow backwards. This is called a “leaky valve” (48).
Abnormal changes in the valve lead to heart murmurs or abnormal heart sounds.

Other causes include:

  • High blood pressure
  • Pregnancy
  • Anaemia
  • Fever
  • Overactive thyroid

Risk factors: The risk factors that heighten the chances of developing a heart murmur are:

  • Family history: If yours is a family of heart defects, it could well increase your risk for heart murmurs.
  • Medical conditions: If you suffer from hypertension, pulmonary hypertension, rheumatoid arthritis, hyperthyroidism, endocarditis, weakened heart muscle, carcinoid syndrome, hypereosinophilic syndrome, rheumatic fever or systemic lupus erythematosus, you can have a higher risk for a heart murmur in adulthood.

Diagnosis: A physical examination usually throws up heart murmurs–something your doctors will be able to hear with a stethoscope. If your doctor finds you have an innocent heart murmur or one that’s caused congenitally, he will ask for you to undergo the following examinations:

  • Electrocardiogram (EKG): This measures the heart’s electrical activity
  • Chest X-rays: The doctor will check the X-ray to see if the heart is enlarged due to a valve or heart disease
  • Echocardiogram: With the help of sound waves, the doctor will be able to map the structure of the heart.

Treatment: Some heart murmurs are harmless, so children and adults don’t need any treatment for this. Some types of heart valve disease may require:

  • Medication: With the right medication, blood clots can be prevented; and low blood pressure and heart palpitations can be controlled
  • Diuretics: By eliminating excess saline from the body, your heart can pump better and easier
  • Surgery: This helps correct congenital heart defects and all types of heart valve disease
  • Antibiotics: Doctors also advise the use of antibiotics to prevent any heart infection before you can go in for dental procedures.
  • Vasodilators to relax and open the blood vessels, thus reducing the pressure against which the heart must pump

Preventing heart murmurs: It’s important to note that a heart murmur isn’t a disease, but it can be treated and managed. You can maintain a heart-healthy lifestyle lifelong which will take care of and prevent many heart valve-related issues. By maintaining an optimal level of blood pressure, and keeping your diabetes and cholesterol levels under check, exercising regularly, quitting smoking and eating mindfully, you can develop a healthy heart.

By following these tips, you can reduce your risk for developing heart murmurs:

  • Eat nutritious food
  • Exercise regularly
  • Practice dental hygiene
  • Quit smoking
  • Reduce alcohol consumption
  • Lose weight

Historically, rheumatic fever was a complication of strep throat (streptococcal pharyngitis) (49). This could cause heart valve damage and the development of a heart murmur. With the advent of good screening tests for strep infections and the appropriate use of antibiotics, rheumatic fever is a rarely diagnosed condition.