Healing A Heart Murmur
You are having a physical exam at your doctor’s office. She listens to your chest with a stethoscope. You have a heart murmur, she says. But she explains that it is nothing to worry about.
A heart murmur describes the sound made by turbulent blood flow within the heart. Think whitewater rapids as opposed to gently flowing river. Often, a murmur occurs with a healthy heart. Sometimes people have murmurs with a normal flow of blood through the heart. In other cases, a murmur may indicate a problem.
Many murmurs are innocent sounds. Children who are on the thin side have innocent murmurs. There is little padding between the stethoscope and the heart. Noises that would not be heard in someone with a large chest are easily heard in a lean child. Murmurs resulting from innocent causes are called functional murmurs.
A murmur may be caused by structural abnormalities of a heart valve. Heart valves usually cause blood to be pumped in one direction. When, for example, blood is being pulled in a wrong direction because of gravity, the valve keeps that from happening.
Heart murmurs also may be due to an abnormal connection between two parts of the heart. A tight or leaky valve may be the cause of heart murmurs. Heart valves control blood flow from the heart’s upper chambers to its lower chambers and from the lower chambers to the rest of the body. A murmur can be heard if a valve becomes narrow, interfering with the outflow of blood. A murmur can also be heard if a leak causes blood to flow backward, in the wrong direction, through a valve.
A condition which may result in a heart murmur is endocarditis. Endocarditis occurs when an infection of the heart valves causes them to be damaged. This can cause a tight or leaky heart valve resulting in a heart murmur.
A very common murmur found mainly in women is a mitral click murmur. The mitral valve separates the left atrium and ventricle. When the ventricle contracts to force blood to the body, the mitral valve snaps shut preventing blood from flowing backwards to the atrium. In some women, there is a loosening of the valve leaflets, allowing them to bulge back into the atrium as a result of the ventricular pressure, a process called “prolapse.” This prolapse can produce a click like noise that can be clearly heard with a stethoscope. A prolapsing mitral valve usually does not cause symptoms. However, in some women it can cause rapid and/or irregular heartbeat and in others it can make the valve more susceptible to infection. These symptoms may require medications.
Children may be born with a congenital opening between chambers of the heart. An example is a ventricular septal defect (VSD) between the right and left ventricles. Blood will travel from the area of highest pressure to lower pressure. Turbulent flow is produced as it crosses the VSD and this creates the typical heart murmur. VSDs can produce symptoms since the blood is bypassing the lungs and are usually repaired surgically.
In adults many things can result in a new murmur. Increased metabolism, such as that seen with an overactive thyroid gland, can produce murmurs. Rheumatic fever at any age can damage the valves of the heart, leading to a leaky valve. These valves often become calcified and hard and function very poorly. If the problem is severe, the damaged valve may be replaced by a valve taken from a pig or one that is completely manmade.
Many heart murmurs don’t cause any symptoms. However, when the heart damage that causes the murmur also causes the heart to malfunction, symptoms occur. They can include shortness of breath, lightheadedness, rapid heartbeat, and chest pain.
Your doctor may need to run several tests in order to find out the cause of the heart murmur. These tests include an echocardiogram (this is the main test to determine the cause of a heart murmur), a chest X-ray (to see if the heart is enlarged), electrocardiogram (measures the electrical activity of the heart), and cardiac catheterization (this is done when other tests fail to come up with a cause for the murmur).
Murmurs that don’t cause symptoms don’t require any treatment, though your doctor should monitor your condition regularly. When treatment is required, it varies based on the cause of the murmur. Medications can treat symptoms. Some medications used to treat serious heart murmurs are blood thinners like warfarin (this medicine is for blood clots which will lessen the threat of strokes), water pills (removes excess fluid from the body), angiotensin-converting enzyme (ACE) inhibitors (lowers blood pressure), and beta blockers (lowers heart rate and blood pressure).
In some cases, surgery may be required to address a heart murmur. The procedure would replace or repair a heart valve. It is dependent on what specific heart condition you have.
It all boils down to the physical examination your doctor gives you. She should be able to decipher what type of heart murmur you have just by listening to your heart with a stethoscope. Keep in mind that most heart murmurs don’t warrant much worry. But address any concerns with your physician.
