What is a heart murmur?
How to Treat an Adult Heart Murmur
Heart murmurs are unusual sounds that the blood makes as it is pumped through your heart. Some heart murmurs are innocent heart murmurs and are not indicative of a condition requiring treatment. Other heart murmurs, however, are abnormal and may require monitoring or treatment.
Recognizing Abnormal Heart Murmurs
Identify the symptoms.If you have an innocent heart murmur, chances are you won’t have any symptoms other than the sounds the doctors hear; however, an abnormal heart murmur can be a sign of a serious underlying condition. If you have any of these symptoms you should see a doctor:
- A bluish tinge to your skin. This may be most likely to occur on your fingers and lips.
- Swelling, especially in your legs
- Unexplained weight gain
- Shortness of breath
- Swollen liver
- Swollen veins in your neck
- Loss of appetite
- Chest pain
Call emergency medical responders immediately if you are having a heart attack.If you are having a heart attack, every minute counts. Some of the symptoms of an abnormal heart murmur are similar to those of a heart attack. If you are unsure, you should err on the side of caution and call emergency medical responders. Heart attack symptoms include:
- Pressure, pain, or a squeezing feeling in your chest
- Pain and tightness that may radiate to your neck, jaw, or back
- Abdominal discomfort
- Heartburn or indigestion
- Shortness of breath
- Cold sweat
- Lightheadedness or dizziness
Ask your doctor about causes of innocent heart murmurs.Innocent heart murmurs may go away over time. They may also remain throughout your life, but never cause any problems. Some causes of temporary, innocent heart murmurs include:
- Extra blood volume during pregnancy
- Fever, anemia, or hyperthyroidism. In these cases, treating the underlying condition should make the heart murmur go away.
Discuss causes of abnormal heart murmurs with your doctor.Some causes are present at birth but not discovered until later, while others may first develop in adulthood. Common causes include:
- Holes in the heart with abnormal blood flow between the chambers. The seriousness of this defect varies based on where it is and how much blood is flowing.
- Valve problems. If the valves don’t allow enough blood to flow through or leak, it may cause a murmur.
- Valve calcification. The valves may become hardened or narrowed with age. This can cause murmurs.
- An infection. Infections of the linings of the heart or valves can cause murmurs.
- Rheumatic fever. This is a complication of untreated or incompletely treated strep throat in which the heart valves are damaged.
Let the doctor listen to your heart.Your doctor will listen to your heart with a stethoscope and consider the following aspects of the murmur:
- The sound. The doctor will be interested in whether it is loud or soft and whether it has a high or low pitch.
- The location of the murmur
- When the murmur occurs during the heartbeat. If it occurs when blood is entering your heart or during the entire heartbeat, that is more likely to be serious.
- Whether you have a genetic predisposition to heart conditions
Get additional tests if your doctor recommends it.Several tests are available which may give your doctor more information. These include:
- A chest X-ray. This exam uses X-rays to create an image of your heart and nearby organs. It would show if the heart is enlarged.
- An electrocardiogram (ECG). During this test the doctor puts electrodes on the outside of your body to measure the electrical signals of your heartbeat. It can measure the rate and rhythm of your heartbeats, and the strength and timing of the electrical signals that control your heartbeats.
- Echocardiogram. This test uses sound waves that are above our hearing range to create a picture of the heart. It can help the doctor view the size and shape of the heart and determine whether there are structural problems with the valves. It can detect areas of the heart that aren’t contracting properly or receiving enough blood flow. During this test you would lie on a table while the doctor uses an ultrasound device against the skin of your chest. It lasts about 45 minutes and does not hurt.
- Stress echocardiogram. During this test you would have an echocardiogram before and after exercising. This examines how your heart works when it is under stress.
- Cardiac catheterization. During this test the doctor uses a tiny catheter to measure the pressure in the chambers of your heart. The catheter would be put into a vein or artery and moved through your body until it reaches your heart. This can also determine if you have any blockage in the coronary arteries.
Treating Abnormal Heart Murmurs
Take medications if your doctor prescribes them.The medication you are prescribed may vary depending on your particular condition and medical history. Commonly used medications include:
- Anticoagulants. These medications reduce blood clots. They reduce the likelihood that a blood clot will form in your heart or brain causing a heart attack or stroke. Common medications include aspirin, warfarin (Coumadin, Jantoven) and clopidogrel (Plavix).
- Diuretics. These medications are used to lower blood pressure, which can reduce the heart murmur. They prevent you from retaining too much water in your body.
- Angiotensis-converting enzyme (ACE) inhibitors. These medications lower blood pressure, and by doing so, can improve your heart murmur.
- Statins. These medications lower cholesterol. High cholesterol can aggravate problems with valves.
- Beta blockers. Beta blockers make your heart beat slower and reduce your blood pressure. This can lessen the murmur.
Repair a damaged or leaking valve.Medications can lower the physical stress on your valves, but if you have a valve that needs to be repaired, it would have to be done through surgery. There are several ways your doctor might do this:
- Balloon valvuloplasty. During this procedure the doctor uses a balloon on the end of a catheter to widen valves that have become too narrow. When the balloon is located at the narrow point, the balloon is expanded. The pressure makes the valve wider.
- Annuloplasty. The surgeon reinforces the area around the valve by inserting a ring. This is used to repair an abnormal opening.
- Surgery on the valve itself or the supporting tissues. This can repair valves that don’t close properly.
Replace a faulty valve.If it is not possible to repair the valve that you have, your doctor may suggest replacing it with an artificial valve. This can be done in several ways:
- Open-heart surgery. Depending on your situation, your doctor may recommend replacing a valve with either a mechanical valve or a tissue valve. Mechanical valves are long lasting, but increase your risk of blood clots. If you have a mechanical valve you would need to take blood-thinning medications for the rest of your life to reduce your risk of heart attacks and strokes. Tissue valves use material from a pig, cow, organ donor, or your own tissue. The drawback is that tissue valves may need to be replaced as they usually don’t last as long. The advantage is that these valves don’t absolutely need long term blood thinners.
- A transcatheter aortic valve replacement. This procedure doesn’t require open-heart surgery. Instead the new valve is inserted with a catheter. The catheter is inserted elsewhere in your body, such as the leg, and used to bring the valve to your heart.
Video: Understanding Heart Murmurs, Aortic and Mitral Valve Problems
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