My Doctor Said I Have a Heart Murmur. What Does That Mean?
If your doctor told you that you have a heart murmur, you’re probably wondering what that means. Is my health in danger? Will I always have a heart murmur? Do I need surgery?
The good news is that many heart murmurs aren’t dangerous. In fact, many heart murmurs go away on their own over a few months or years.
Whether you need treatment for your heart murmur will depend on what type of murmur you have. Even if you need treatment, your heart doctor (cardiologist) will work with you to decide what treatment is best and least invasive.
What Is a Heart Murmur?
A heart murmur is when your heart makes an unusual sound as blood is flowing through your heart.
You’re probably used to your doctor listening to your heartbeat through a stethoscope. If you have a heart murmur, your doctor will hear a sound that’s different from normal while your blood is flowing through your heart’s chambers.
Another way to think about a murmur is the uncommon sound that blood makes while it flows through your heart.
- Hearts that don’t have a murmur make a “lub dub” sound.
- Hearts that have murmurs make a swishing or whooshing sound.
Many heart murmurs aren’t life-threatening and don’t need treatment. But other heart murmurs do need treatment because they’re a sign of an underlying problem with your heart.
It’s important to remember that if you’ve been diagnosed with a heart murmur, that doesn’t mean you’ll always have it. Heart murmurs can go away on their own.
How Many People Have Heart Murmurs?
Heart murmurs are very common:
- 10 percent of adults will have a heart murmur.
- 40—45 percent of children have a heart murmur.
Most children with murmurs have a congenital heart murmur, meaning they were born with it.
Is Having a Heart Murmur Dangerous?
Whether a heart murmur is dangerous depends on what’s causing it in the first place.
- Heart murmurs that are caused by normal life activities (like exercising, being pregnant, or having a fever) usually aren’t dangerous and don’t need treatment. (These are called innocent heart murmurs)
- Heart murmurs that are caused by diseases or structural problems in your heart may need treatment. (These are called abnormal heart murmurs)
Abnormal Heart Murmurs
Heart murmurs that are caused by infections, birth defects, or diseases can be dangerous. Problems may include:
Endocarditis is an infection in the heart’s valves and inner lining. This infection can seriously damage your heart's valves.
Septal defects are holes inside the heart. People who have septal defects were usually born with them. Whether or not septal defects are dangerous depends on where the holes are and how big they are.
Heart Valve Diseases
Even though many people with heart valve problems were born with them, many adults don’t find out they have valve problems until they’re years older.
Valve problems include:
- Aortic valve stenosis: this is when your aortic valve becomes thickened and narrowed. This narrowing makes it harder for your heart to pump blood out to your body. It may cause symptoms like shortness of breath and fatigue.
- Mitral stenosis: this is when your mitral valve becomes narrowed, making it harder for blood to flow from your left atrium to your left ventricle. Mitral stenosis is often caused by rheumatic heart disease (from past strep throat infections). Mitral stenosis can cause shortness of breath and fatigue.
- Aortic root aneurysm: this is when the first part of your aorta dilates (becomes wider than it should). Aortic root aneurysms can cause your aortic valve to work incorrectly, which can cause a heart murmur. Many conditions, including genetic disorders like Marfan Syndrome, can cause aortic root aneurysms. Cardiologists and surgeons who specialize in treating aortic disease can evaluate and manage this type of aneurysm.
- Mitral regurgitation happens when blood leaks backward through your mitral valve when your heart beats. If it’s not treated, mitral regurgitation can cause heart failure.
- Aortic insufficiency: this happens when blood leaks backward through your aortic valve in between heartbeats. It can also cause heart failure if it’s not treated.
- Tricuspid regurgitation: this happens when blood leaks backward through the valve on the right side of your heart. If it’s not treated, tricuspid regurgitation can cause abdominal or leg swelling, liver failure, and heart failure.
Cardiologists and cardiothoracic surgeons are doctors who specialize in treating heart valve diseases. These doctors can recognize and diagnose valve diseases that may be missed by other doctors.
Innocent Heart Murmurs
Heart murmurs that aren’t dangerous or life-threatening are sometimes called “innocent heart murmurs.” One of the reasons these types of heart murmurs happen is because blood flows more quickly through your heart than normal.
You may have an innocent (non life-threatening) heart murmur if:
- you’re pregnant;
- you have a fever;
- you’re exercising or doing other physical activity;
- you’re anemic (your blood cells don’t carry enough oxygen to your tissues and muscles);
- you have hyperthyroidism (you have too much thyroid hormone); or
- you’re a teenager and your body is growing quickly.
Heart Murmur Symptoms
If you have an innocent heart murmur, you probably won’t have any symptoms. But if you have these symptoms, you may have an abnormal heart murmur:
- shortness of breath,
- chest pain,
- a cough that won’t go away,
- blue skin around your lips and fingertips,
- a lot of sweating—even when you're not exercising strenuously or exerting yourself.
These symptoms may be a sign of an underlying heart disease that hasn’t been diagnosed.
Do Heart Murmurs Need Surgery?
Not all heart murmurs need to be treated with surgery. Instead, your treatment will depend on what’s causing your heart murmur in the first place.
If you have an innocent heart murmur, you probably won’t need any treatment.
Some abnormal heart murmurs can be managed with medication. Some common medications used to treat heart murmurs include the following:
- statins—medications that lower your cholesterol
- beta blockers or ACE inhibitors—medications that lower your blood pressure
- aspirin or warfarin—these medications are anti-coagulants because they help prevent blood clots from forming
If something is wrong with your heart—for example, if you have a hole in your heart or one of your heart valves needs to be replaced—then you may need surgery.
Heart Murmur Treatment
Surgeries for heart murmurs often include valve repair and valve replacement. These surgeries treat the underlying valve problems in your heart that are causing the murmur. If you do need surgery, your cardiothoracic surgeon will try to make sure your surgery is as minimally invasive as possible.
Transcatheter Aortic Valve Replacement
Transcatheter aortic valve replacement (also known as TAVR or TAVI) is also a good treatment option for patients who can't have surgery, or for patients who want a less invasive option than open heart surgery.
The MitraClip is a tiny device (about the size of a dime) that treats mitral regurgitation. The MitraClip pinches your mitral valve so it can close more fully. Closing your mitral valve stops blood from leaking backwards.
Getting a MitraClip doesn’t involve surgery since doctors don’t have to open your chest. Instead, your doctor will insert your MitraClip through a thin tube (catheter) that runs through your leg and into your heart.
Many heart murmurs are innocent and don’t need treatment. But it’s important to see a cardiologist or cardiothoracic surgeon if:
- your primary care doctor has told you that you have a heart murmur, and you have symptoms of an abnormal heart murmur, or
- you have the symptoms described above and you think you may have an abnormal heart murmur.
At University of Utah Health, a heart team that includes a cardiologist and a cardiothoracic surgeon will evaluate your heart murmur. Your heart team will examine your heart and rule out any serious, undiagnosed heart conditions that may need treatment.
Call 801-585-7676 to schedule an appointment with a cardiovascular specialist