The Lub-Dub Lowdown: 5 Things to Know About Heart Murmurs

It’s some­thing that has prob­a­bly hap­pened to you dozens of times, whether you’re at your annu­al phys­i­cal, you’re at imme­di­ate care for a nasty cough, or you’ve tak­en a trip to the emer­gency room: Your provider has lis­tened to your heart with their stethoscope.

You know they’re lis­ten­ing to your heart­beat, but what exact­ly are they lis­ten­ing for when they press their stetho­scope against your chest?

They’re look­ing for that famil­iar ​“lub-dub” — the sound of your heart valves open­ing and clos­ing as blood flows through the heart. But some­times, that rhyth­mic ​“lub-dub” is inter­rupt­ed by an abnor­mal swish­ing, whoosh­ing, or blow­ing noise in between heart­beats. This extra noise is called a heart mur­mur. Heart mur­murs are actu­al­ly very common.

Here are 5 things to know if you or your child have been told that you have a heart murmur.

1. Many mur­murs are com­plete­ly innocent.

In gen­er­al, there are two types of heart mur­murs: inno­cent and abnormal.

Inno­cent mur­murs are harm­less sounds made as blood flows nor­mal­ly through a healthy heart or blood ves­sels close to the heart. Many infants and chil­dren have these types of mur­murs, since their hearts are close to their chest walls and it’s easy to hear the blood flow. The mur­murs often dis­ap­pear dur­ing adult­hood, but they can some­times stick with some­one through­out their life. 

These mur­murs can pop up when blood flows quick­er through the heart than usu­al. Exer­cise and phys­i­cal activ­i­ty, preg­nan­cy, and rapid growth spurts can all bring on an inno­cent murmur.

If you find out that you or your child have an inno­cent mur­mur, rest easy. Inno­cent mur­murs do not cause any symp­toms and are not a type of heart dis­ease. They don’t require any treat­ment and should not stand in the way of liv­ing a nor­mal life. Plus, they are total­ly nor­mal — up to 72% of chil­dren and ado­les­cents may have a mur­mur at some point.

2. You still need to take heart mur­murs seriously.

Abnor­mal mur­murs are caused by oth­er prob­lems in the heart. Some of the most com­mon include:

• Valve prob­lems can occur in any of the four heart valves. The valves are respon­si­ble for let­ting blood flow from the heart’s upper cham­bers to the low­er cham­bers. Sev­er­al types of valve prob­lems can cause heart mur­murs, such as:

• Steno­sis (a nar­rowed valve that doesn’t open correctly)

• Regur­gi­ta­tion (a leaky valve)

• A hole in the sep­tum, which is the wall divid­ing the left and right upper or low­er cham­bers of the heart

• Patent duc­tus arte­rio­sus (the duc­tus arte­rio­sus blood ves­sel doesn’t close after birth) – caus­ing abnor­mal flow between cham­bers of the heart. 

• Endo­cardi­tis is an infec­tion and swelling of the lin­ing of the heart (endo­cardi­um) and the valves that can obstruct blood flow or cause blood to leak backwards.

• Car­diomegaly is an enlarged heart. If the heart is too large, it can have dif­fi­cul­ty pump­ing blood efficiently. 

While mur­murs them­selves aren’t symp­to­matic, the under­ly­ing caus­es can lead to symp­toms like dizzi­ness, short­ness of breath, or chron­ic cough. 

Do you have ques­tions about your heart mur­mur? Sched­ule an appoint­ment with a Duly Health and Care cardiologist.

3. There are sev­er­al ways to deter­mine the type of heart mur­mur — and what’s caus­ing it.

You can’t hear a heart mur­mur with­out lis­ten­ing to your heart through a stetho­scope. That’s why most mur­murs are found dur­ing rou­tine exams, when your provider is check­ing your heartbeat.

So — how does your provider know if it’s inno­cent or abnormal?

When they first hear the mur­mur, they can clas­si­fy it on a scale from 1 to 6, with 6 being the loud­est and most intense. Mur­murs that are grad­ed high­er on the scale may be a bit more worrisome.

They will also eval­u­ate the tim­ing of the mur­mur, and when it occurs in the heart­beat. A sys­tolic mur­mur, which hap­pens as blood is leav­ing the heart, is often inno­cent. How­ev­er, a mur­mur that occurs when the heart is fill­ing up with blood (dias­tolic) or that goes through the entire heart­beat (con­tin­u­ous), is more suspect. 

If your provider does sus­pect that it’s more than an inno­cent mur­mur, they may rec­om­mend some addi­tion­al tests, like x‑rays or elec­tro­car­dio­grams.

Source: Nation­al Library of Medicine

4. Mur­murs them­selves don’t require treatment. 

You don’t need treat­ment for a mur­mur — but you may need treat­ment for what is caus­ing it. Many of the dis­eases and con­di­tions that cause mur­murs can be treat­ed with med­ica­tion. In cer­tain cas­es, where the dis­ease is severe, you may need surgery.

If you know that you or your child have a heart mur­mur — even an inno­cent one — always be on the look­out for signs of a more seri­ous con­di­tion, like con­stant­ly being very tired or hav­ing dif­fi­cul­ty exer­cis­ing and being phys­i­cal­ly active. Call your provider or your child’s provider right away if you notice:

• Chest pain

• Dif­fi­cul­ty feeding

• Fast breath­ing

• Short­ness of breath

• Bluish tint to the lips or skin

• Swelling in the legs

5. You don’t need to panic.

Remem­ber — a heart mur­mur itself isn’t a form of heart dis­ease. Even if you have an abnor­mal mur­mur, the con­di­tion caus­ing it is often treat­able. Most mur­murs are not seri­ous and won’t stand in the way of liv­ing a nor­mal, healthy life.