Heart Murmur in Newborns

Introduction

A heart murmur in a newborn is an additional sound heard during a heartbeat, often detected during routine check-ups. While it can be concerning for parents, not all murmurs indicate a serious problem. Many are harmless (also called "innocent murmurs"), while others may suggest underlying heart conditions.

Understanding Heart Murmurs

A heart murmur is a sound made by turbulent blood flow within the heart. These murmurs can be categorized into: - Innocent (Physiological) Murmurs: These are common and do not indicate heart disease. They often disappear as the child grows. - Pathological Murmurs: These are caused by congenital heart defects or other abnormalities requiring medical attention.

Causes of Pathological Murmurs

Pathological murmurs may indicate: - Congenital Heart Defects (CHD): Structural abnormalities like ventricular septal defect (VSD) or atrial septal defect (ASD). - Valve Disorders: Abnormalities in heart valves causing improper blood flow. - Patent Ductus Arteriosus (PDA): A condition where a fetal blood vessel fails to close after birth. - Coarctation of the Aorta: A narrowing of the aorta affecting blood circulation.

Diagnosis and Tests

To determine the significance of a heart murmur, doctors may perform: 1. Physical Examination: Evaluating the murmur’s characteristics (timing, intensity, location). 2. Echocardiogram: Ultrasound imaging to visualize heart structures. 3. Electrocardiogram (ECG): Measures heart electrical activity. 4. Chest X-ray: Assesses heart and lung anatomy.

Treatment and Management

  • Innocent murmurs require no treatment and usually resolve naturally.
  • Pathological murmurs need rigorous follow-up and may require medications, catheter-based procedures, or surgery for correction.

When to Seek Medical Attention

Parents should consult a pediatric cardiologist if their newborn exhibits: - Difficulty breathing - Poor feeding - Cyanosis (bluish discoloration of skin) - Excessive sweating - Poor weight gain

Conclusion

Most newborn heart murmurs are harmless. However, timely diagnosis is crucial for pathological causes to ensure appropriate management and better health outcomes.

Source recommendations

1. American College of Cardiology/American Heart Association Guidelines for the Management of Congenital Heart Disease

  1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000603
  2. https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2018/08/13/16/26/2018-AHA-ACC-Guideline-for-the-Management-of-ACHD
  3. https://pubmed.ncbi.nlm.nih.gov/30121240/
  4. https://www.acc.org/Guidelines
  5. https://www.jacc.org/guidelines/achd

2. European Society of Cardiology Guidelines on Congenital Heart Disease

  1. https://academic.oup.com/eurheartj/article/42/6/563/5898606
  2. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Grown-Up-Congenital-Heart-Disease-Management-of
  3. https://pubmed.ncbi.nlm.nih.gov/32860028/
  4. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines
  5. https://pubmed.ncbi.nlm.nih.gov/20801927/

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