Heart Murmurs Unveiled: A Deep Dive into the Causes, Implications, and Management of These Unique Cardiac Sounds

A person's heartbeat usually follows the "lub-dub, lub-dub" rhythm. However, some individuals have additional whooshing or rasping sounds accompanying this two-tone heartbeat, which are known as heart murmurs. But what precisely are these cardiac sounds, and what leads to their occurrence?

Possible Causes of Heart Murmurs

Dr. Kenneth Ellenbogen, a cardiology professor at the Virginia Commonwealth University School of Medicine, explains that heart murmurs can range from harmless conditions to potential valve issues that require further evaluation or treatment.

These murmurs are typically caused by the coordinated closure of different heart valves during the heart's contracting process, which produces the rhythmic "lub" and "dub" sounds.

When blood moves from the atria to the ventricles, valves close to prevent backflow, creating the "lub" sound. As blood is ejected into the arteries from the ventricles, the valves that separate the heart from the arteries close, leading to the "dub" sound.

However, disruptions in this blood flow can produce whooshing, humming, or rasping sounds that are characteristic of heart murmurs and are detectable when a physician listens to the heart with a stethoscope. These murmurs may result from irregularities in the heart's structure, such as valve abnormalities, congenital heart defects, or infectious diseases like bacterial endocarditis and rheumatic fever.

Additionally, heart murmurs that do not stem from structural abnormalities or heart diseases are referred to as "innocent" or "physiological" and are typically caused by a significant increase in blood flow through the ventricles, leading to audible murmurs.

Implication of Heart Murmurs

Heart murmurs come in two categories: "innocent" and "abnormal." Innocent murmurs are often found in infants and young people during growth spurts when their bodies require increased blood flow. These murmurs affect around 30% of children aged 3 to 7 and approximately 10% of adults. Innocent murmurs can also occur during pregnancy, typically between weeks 12 to 20, due to the increased blood volume necessary for fetal development.

Abnormal heart murmurs may not always show symptoms but can be linked to issues like breathing difficulties, chest pain, sweating, weight gain, bulging neck veins, and chronic cough. In infants and young children, they can lead to problems with feeding, poor growth, and fussiness. Common causes of heart murmurs include an overactive thyroid, untreated high blood pressure, and intense exercise that raises the heart rate.

Risk factors for heart murmurs include intravenous drug use and a family history of cardiac defects. Furthermore, existing heart murmurs can become louder during fever or anemia, as these conditions affect blood thickness and necessitate a faster heart rate for effective blood circulation.

Managing Heart Murmurs

Heart murmurs often don't require treatment and are generally not a cause for concern. However, if a murmur is linked to a more severe underlying condition, treatments like medications (e.g., iron supplements for anemia or thyroid-regulating drugs) and surgical procedures to correct or replace heart valves may be necessary.

Preventing heart murmurs is challenging as they can't be avoided, but potential complications from heart conditions can be minimized by regular heart check-ups. The prognosis for individuals with heart murmurs varies according to the condition causing it.

Childhood murmurs often resolve as kids grow, and pregnancy-related murmurs typically disappear after childbirth. However, murmurs connected to heart conditions require medical attention.

If any signs of a heart problem such as bluish skin, chest pain, heart palpitations, shortness of breath, or weakness are observed, it is essential to seek medical assistance promptly. A heart murmur is a swishing or whooshing sound that arises when blood moves irregularly over heart valves. While many murmurs are harmless, they should be evaluated to rule out any underlying health issues.