A heart murmur is an unusual or extra sound heard during a heartbeat. Murmurs can range from faint to loud, and often sound like a whooshing or swishing noise. Heart murmurs can be due to congenital heart defects, valve abnormalities, infections in the heart or heart failure. Some heart murmurs are harmless, while others indicate a serious abnormality.

Causes

Functional or physiologic heart murmurs occur in at least half of all children at some time. They may last throughout an individual’s life without ever causing problems. Functional heart murmurs may increase in intensity during fever, pregnancy and anemia.

Among the conditions that can cause pathologic heart murmurs are:

• Structural heart defects present from birth
• Valvular heart diseases, such as those associated with rheumatic fever
• Endocarditis (an infection in the heart)
• Mitral valve prolapse
• Congenital heart defects
• Heart failure

Symptoms

Symptoms include:

• Shortness of breath
• Heavy sweating with little exertion
• Chest pain
• Dizziness
• Fainting
• Enlarged neck veins
• Enlarged liver

If you have these symptoms, a physician experienced in heart conditions should evaluate you.

Why choose Ohio State for heart murmur treatment?

Ohio State's Wexner Medical Center provides an integrated approach to treating heart disease, including murmurs. Patients are often referred to our cardiologists for evaluation of heart murmurs; if the murmur turns out to be the result of a serious heart problem, the cardiologist may follow the patient or refer him or her for treatment.

Diagnosis

A physician listening to the heart with a stethoscope during a routine physical examination detects most heart murmurs. Heart murmurs are graded on a scale from 1-6, with six reflecting the loudest murmur.

Tests a physician uses to confirm the diagnosis of a pathologic heart murmur include:

• Electrocardiogram (EKG/ECG) – A test that records the electrical activity of the heart
• Echocardiogram (also called echo) – This test uses sound waves to assess the function and structure of the heart muscle and valves
• Cardiac MRI (cardiac magnetic resonance imaging or CMR) – A noninvasive, sophisticated imaging procedure that uses large magnets and a computer to produce detailed images of the structure and function of the heart while it is beating
• Cardiac catheterization – A procedure to check for problems in coronary arteries. A long, thin tube (catheter) is inserted into an artery or vein in the groin, arm or neck, then threaded to the heart. The physician injects a contrast solution into the artery and takes X-rays to check for blockage and other abnormalities.

Treatments

Generally, heart murmurs do not require treatment. However, pathologic heart murmurs may require treatment or at least monitoring over time. Treatment may include medication, surgery or other procedures performed in the cath lab.

Medications

Anticoagulants, beta blockers, diuretics and angiotensin-converting enzyme (ACE) inhibitors are among the many medications prescribed for most heart problems.

Surgery and other procedures

Surgeries and procedures to treat heart murmurs can include:

• Mitral valve repair or replacement 
• Repair of a hole in the heart
• Open heart surgery 
• Aortic valve replacement
• Balloon valvuloplasty