What To Do about a Heart Murmur

By: Dr. Ryan D. Melchior

A heart murmur is the sound of abnormal blood flow across a valve in the heart and presents itself as unusual sounds between heartbeats. A heart murmur isn't always a sign of something serious -- but it's always worth investigating with your doctor. When your physician identifies a heart murmur it is important to figure out the underlying cause and what can be done to address the potential problem before it becomes more serious.

Determining the Cause

During the physical exam your physician will listen to your heart with a stethoscope. This allows your doctor to classify the heart murmur into one of two categories:

● Systolic heart murmurs occur when the bottom heart chambers contracts
● Diastolic heart murmurs occur when the heart refills with blood

Systolic and diastolic heart murmurs have different causes and help your physician identify the root cause of the murmur.  Short or quiet murmurs are more likely to be “innocent” murmurs and no further treatment is indicated. 

If further evaluation is required, your physician will typically follow up with an echocardiogram, an ultrasound of the heart. This non-invasive test takes two- and three-dimensional pictures of the heart. These pictures can help direct next steps and potential treatment options.


Heart Murmur Treatment

As discussed above, a heart murmur may be "innocent" and not indicative of further treatment. Many live with heart murmurs all their lives and never experience ongoing health issues.

But, a heart murmur may be a sign of aortic stenosis.  Aortic stenosis is a narrowing of the aortic valve opening typically caused by calcification. This narrowing obstructs blood flow from the heart to other parts of the body and makes the heart work much harder. The condition occurs most often in elderly individuals – up to 10% of those over the age of 70 will develop it. Without surgical intervention, the heart of a patient suffering from aortic stenosis can fail.

Fortunately, treatment options have advanced and open-heart surgery is no longer the only option for addressing aortic stenosis. Transcatheter Aortic Valve Replacement is a new minimally invasive procedure that repairs the damaged valve by placing a new valve within the old valve. The new valve is inserted on a catheter, through a large femoral artery in the groin. A stent holds the valve insert in place, and the new valve starts working immediately.

If your physical exam indicates a heart murmur additional assessment and testing may be required to determine the degree and severity.  If you have a concern, discuss your symptoms with your healthcare provider.


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