Heart Murmur - what does it mean if you have one?

As far back as I can remember, I had a heart murmur. I recall a flurry of concern about it when I was quite small, but ultimately the doctors decided it was an "innocent murmur."

Over the years, every time a new doctor heard it, there were questions - but when I said I'd always had it, and because I was otherwise as healthy as a horse, they'd just make a notation on the file and not pursue it any further.

What is an innocent murmur?

Murmurs are sounds, beyond the normal "lubb-dupp" sound of the heart beat, made by blood moving through the valves and blood vessels of the heart. A murmur does not necessarily indicate a disease or disorder, and not all heart disorders cause murmurs.

Innocent murmurs are common in children. They can come and go and generally they disappear by adulthood - but not always. Innocent murmurs are also known as "functional murmurs" or "vibratory murmurs." They are harmless.

Not all heart murmurs are innocent

Today, we have better ways of assessing if a murmur is "innocent" than we had in the past - say when I was a child in the 1950s for instance.

A heart murmur may be the sound of valve disease, a valve that is not functioning properly - when the opening is too tight (stenosis) and the heart is struggling to push the blood through, or when the opening is slack and there is blood leaking backward (regurgitation) through the valve.

It can indicate that blood is following an abnormal path through the heart - for example, through a hole between ventricles or due to an obstruction.

In my case, I learned at age 51 that I had aortic stenois and subsequently that the stenois was the result of a bicuspid (two flap instead of three) aortic valve. It may be that my murmur was "innocent" for many years, but today my murmur is most definitely related to the stenosis of the aortic valve.

How is a murmur detected and its cause identified?

Your doctor can hear a murmur by listening with a stethoscope. These sounds can be further tested with an echocardiogram to find the cause of the murmur. Your doctor may also want an electrocardiogram and a chest x-ray to help identify the cause.





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