Are Heart Murmurs Bad? Defining the Problem

By: Dr. Ryan D. Melchior

If you've ever felt a heart murmur, or if you've been told by a doctor that you have one, the first thing you might feel is concern. What are heart murmurs? Where and why do they occur? Are heart murmurs bad? In this article, we explain what they are, why they matter, and how they're generally discovered.

What Are Heart Murmurs?

The human heart has four chambers: two on the top, called the atria, and two on the bottom, known as the ventricles. There are valves at the end of each of these four chambers, through which the blood flows. A heart murmur is blood flowing more turbulently than normal across these valves. Some types of heart murmurs may disappear in time or last a lifetime without negatively impacting health. Other heart murmurs may be a sign of valvular disease.

Why Do Heart Murmurs Matter?

At the most basic level, a heart murmur is abnormal blood flow across a heart valve.

This could potentially be caused by the following:

● A leakage in the valve, causing blood to flow backward
● Tightening of the valve, a condition called stenosis

Both leakages and tightening of the valve can lead to heart problems and potentially increase mortality. It is important that any murmurs be investigated to determine the cause and identify treatment options.

In most cases, a doctor will notice the murmur during a routine physical exam. The next step is to perform an echocardiogram, essentially an ultrasound for the heart. The echocardiogram allows the doctor to see the valves and examine the pressure gradients across the valves. In some instances, especially for older patients with known valvular heart disease, doctors may perform yearly echocardiograms to watch for developing issues.

Finding Out You Have a Murmur

How does a heart murmur get noticed? Often, it is diagnosed by a primary care physician during a general screening physical or examination. In many cases, a patient is referred to a cardiologist for an echocardiogram, particularly if they have a family history of heart problems.

Patients who have diabetes, underlying coronary artery disease, or structural heart disease are more likely to have heart murmurs. Heart murmurs also increase as a natural by-product of aging -- around 25% of patients over the age of 65 experience heart murmurs due to a condition called aortic valve sclerosis, a natural thickening of the valves of the heart that occurs with age.

One of the first steps we take at VCS is to determine whether a murmur is due to normal aging and thickening of the valve, or a sign of something more significant. Some patients have mild abnormalities that lead to murmurs, and won't experience any health risks and no further treatment is needed.

If you think you have a heart murmur, or if you have questions about treatment options contact your physician.  Understanding your overall cardiac health is important to obtaining appropriate treatment.


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