Heart Murmur: Causes, Diagnosis, and Treatment

Introduction

A heart murmur is an abnormal sound heard during a heartbeat, often described as a whooshing or swishing noise. It can be harmless (innocent) or indicative of an underlying heart problem (pathologic). Understanding the causes, diagnosis, and treatment options is essential for managing this condition properly.

Causes of Heart Murmurs

Heart murmurs occur when blood flows more turbulently than normal through the heart. The common causes include: - Innocent Murmurs: These occur in healthy people and do not indicate heart disease. - Congenital Heart Defects: Structural problems present from birth, such as septal defects or valve malformations. - Valve Disorders: Conditions like mitral valve prolapse, aortic stenosis, or regurgitation can cause murmurs. - Endocarditis: Infection of the heart valves leading to valvular dysfunction. - Rheumatic Heart Disease: A complication of untreated streptococcal infection affecting heart valves. - Anemia, Hyperthyroidism, or Fever: Increased blood flow speed may create a murmur.

Diagnosis

To determine the cause of a heart murmur, doctors use: 1. Physical Examination: Listening with a stethoscope to assess the murmur’s characteristics. 2. Echocardiography: Ultrasound imaging of the heart to assess structural abnormalities. 3. ECG (Electrocardiogram): Evaluates the heart’s electrical activity. 4. Chest X-ray: Checks for heart enlargement. 5. Cardiac MRI or CT: Detailed imaging for complex cases.

Treatment Options

Treatment depends on whether the murmur is innocent or due to disease: - No Treatment Needed for innocent murmurs. - Medications for associated conditions: - Beta-blockers or calcium channel blockers for heart strain. - Antibiotics if an infection (endocarditis) is present. - Blood thinners for clot prevention. - Surgical Interventions: - Valve Repair/Replacement: If valve disease is severe. - Repair of Congenital Defects: Surgical correction in children or adults with structural issues.

Conclusion

While many heart murmurs are harmless, some signal serious heart conditions requiring medical intervention. If you or a loved one has a murmur, consult a cardiologist for a proper evaluation.

Source recommendations

1. American Heart Association Guidelines for Valvular Heart Disease

  1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000923
  2. https://www.heart.org/en/health-topics/heart-valve-problems-and-disease
  3. https://pubmed.ncbi.nlm.nih.gov/33332149/
  4. https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/heart-valve-disease-resources
  5. https://professional.heart.org/en/guidelines-and-statements

2. European Society of Cardiology Guidelines on the Management of Valvular Heart Disease

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Valvular-Heart-Disease-Guidelines
  2. https://academic.oup.com/eurheartj/article/43/7/561/6358470
  3. https://pubmed.ncbi.nlm.nih.gov/34453165/
  4. https://www.jacc.org/doi/10.1016/j.jacc.2023.05.061
  5. https://pubmed.ncbi.nlm.nih.gov/17259184/

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