How serious is your heart murmur?

Cardiologists are doctors who specialize in care for your heart and blood vessels. A heart murmur is an unusual or extra sound in a heartbeat. Heart murmurs are often congenital, meaning it's a problem you've had since birth.

We often see people come into the cardiology department with chest pain, shortness of breath and related symptoms. Sometimes they were told as children they had a heart murmur and it never came up again. But heart murmurs can lead to serious symptoms.

Heart murmurs are common in children 

Heart murmurs are not always a problem. There are two kinds of heart murmurs:

• Innocent (harmless)
• Abnormal (potentially harmful) 

Most children have innocent heart murmurs and can live without any symptoms. For some children, the murmur can be abnormal and caused by a congenital heart defect or problem. Doctors may notice the heart murmur at birth, but later it may not be noticeable.

Murmurs heard through a stethoscope are dynamic. That means we can hear a murmur, but it may come and go and change. The changes depend on a person's blood vessels, blood pressure, lung health or chest wall differences.

Diagnosing heart murmurs can be difficult. Because of this difficulty, sometimes heart murmurs are missed. Listening for an abnormality is one thing, but knowing what you're listening for and knowing when it may be time for treatment requires a heart expert.

When a heart murmur becomes a problem

When undetected or not closely followed, an abnormal heart murmur can create cardiovascular problems later in life or maybe sooner.

A heart valve keeps blood moving in the heart. Heart valve abnormalities may lead to one or more problems, such as: 

• Stenosis, or not enough blood getting to the heart, leading to the heart not pumping normally
• Regurgitation, or the heart not closing properly, leading to leaking 

Other congenital problems like "hole in the heart" (septal defect) and cardiac shunts (abnormal heart blood flow) can also affect the size of the heart and how it works. These problems can also lead to heart murmurs.

Most people in the United States with heart valve disease don't have symptoms for very long periods in their lives. Often their cardiologist will find the problem because of someone having symptoms.

Heart valve disease symptoms may include:

• Fatigue
• Shortness of breath
• Not able to do exercise or a lot of physical movement
• Lightheadedness
• Swollen ankles, feet or belly
• Difficulty breathing when lying flat to sleep
• Palpitations or fluttering heart beats 

Often these symptoms start unexpectedly and without a known reason. This can be frustrating and sometimes cause fear or worry.

What you can do about heart murmur problems

Take early steps to understand heart murmur symptoms and diagnosis. This will help you work on keeping your heart strong and healthy. It will also help you stop major heart problems later in life.

Cardiologists are trained specifically in:

• Finding heart valve disease
• Stopping problems from happening or getting worse
• Screening for adult congenital heart disease (ACHD)

If you have been told you have a heart murmur and you think you have symptoms of heart valve disease, you should:

• Talk to your doctor and ask if you should see a cardiologist, especially if you’ve had shortness of breath, palpitations or chest pain.
• See a cardiologist. If you’ve been told you have a “hole in your heart," mitral valve prolapse or a bicuspid valve, make an appointment to see if there’s more you should do to follow up.

The information provided is for general informational purposes only and is not intended to be medical advice or a substitute for professional health care. You should consult an appropriate health care professional for your specific needs.