Heart murmurs are common in kids and adults and while there are scenarios in which patients need intervention, many times murmurs don’t require any specialized treatment.
“I think that it can be very frightening for people to hear they have a murmur,” said Yale Medicine cardiologist Sara Tabtabai, MD, FACC, of the Heart and Vascular Center (HVC). “We certainly have lots of different things that can cause the sound of a murmur but some of them are reversible and do not necessarily mean you have an underlying valve problem.”
What are heart murmurs?
A heart murmur is a “whooshing” sound made in addition to the normal heartbeat that indicates blood flow. A murmur can be heard with a stethoscope and where they land in between heartbeats as well as how loud they are can potentially indicate what type of murmur it is.
Heart murmurs in kids
In kids, most murmurs are physiologic, meaning the heart does not have any structural concerns.
“People are worried if their child has a murmur, that means they have a heart problem. However, the majority of childhood murmurs are benign or physiologic murmurs and those do not have symptoms or structural heart problems associated with them” said Yale Medicine pediatric cardiologist Dina Ferdman, MD, co-director of Yale New Haven Children’s Hospital’s Fetal Care Center.
Benign murmurs don’t require treatment or follow-up care.
Pediatric murmurs can also be a sign of congenital heart disease, which is a structural heart problem present since birth. Major congenital heart defects can often be detected through fetal imaging before a baby is born.
“The most common cause of a heart murmur in a newborn due to congenital heart disease is a small ventricular septal defect, which is a small opening between the chambers of the heart. The majority of these will spontaneously resolve on their own as the child grows. We’ll keep an eye on the child as they’re getting bigger and continue listening to them until healed,” said Dr. Ferdman.
For those defects that don’t resolve on their own, children may need additional treatments including things like medications or surgical interventions. Children diagnosed with a significant congenital heart defect requiring surgical intervention will need to be cared for by a pediatric cardiologist until adulthood when they transition to care with an adult congenital cardiologist.
Heart murmurs in adults
Just like with kids, heart murmurs in adults can sometimes be benign. They can be caused by changes in blood flow due to conditions such as pregnancy, anemia or fever.
In adults, murmurs can also indicate an underlying valve issue. For example, aortic stenosis is a condition where the valve has thickened, restricting blood flow to the aorta.
Mitral valve regurgitation is another condition that occurs when valve leaflets do not open and close properly, resulting in blood leaking back into the chamber of the heart instead of moving forward.
Symptoms associated with these kinds of murmurs may include:
- Shortness of breath
- Sweating
- Fainting
- Trouble breathing
- Chest pain
“Long term, if the valves are not working well and they're causing the sound of a murmur, you can get remodeling or changes in the structure of the heart muscle itself, which can lead to heart failure over time,” said Dr. Tabtabai.
Treatment options depend on each patient’s needs. For example, a leaky valve may need to be repaired or replaced. But Dr. Tabtabai says even in the event of a valve issue, sometimes patients don’t need surgical intervention.
“There are clear guidelines as to what needs to be fixed and when and it's usually only when valve disease gets into a severe category of either leakiness or stenosis that we would need to do something about it,” said Dr. Tabtabai. “Very often the recommendation is going to be that we’ll monitor the patient.”
Learn more about pediatric heart murmurs and adult care at Yale New Haven Health's Heart and Vascular Center.
