What Did You Hear – Is that a Murmur?

What are Heart Murmurs?
A murmur is an extra sound that your doctor hears while examining your child’s heart. The sound is produced by the movement of blood through the valves and chambers in your heart.  Murmurs are graded on a scale of 1 to 6, with 1 being very faint and 6 being very loud and there are four types of murmurs.

• Systolic murmur – a heart murmur that occurs when the heart contracts
• Diastolic murmur – a heart murmur that occurs when the heart relaxes
• Holosystolic Murmurs- a heart murmur that occurs for the entire duration that the heart contracts
• Continuous murmur – a heart murmur that occurs throughout the heart cycle

What Causes a Heart Murmur in a Child?
Heart murmurs are very common in normal, healthy children. These may be called innocent murmurs.  In fact, the vast majority (95%) of heart murmurs are normal. Or a child may be born with a heart defect that causes a murmur. Other noncardiac causes include:

• Infection
• Fever
• Low red blood cell count (anemia)
• Overactive thyroid gland (hyperthyroidism)

What Are the Symptoms of Heart Murmurs in a Child?
Children with innocent murmurs have no other symptoms except the noise the blood makes moving through the heart.  A child with a heart murmur caused by a heart problem may have the following symptoms. Remember, the symptoms can vary depending on the problem.

• Poor feeding, eating, or weight gain
• Shortness of breath or breathing fast
• Sweating
• Chest pain
• Dizziness or fainting (syncope)
• Bluish skin, especially of the tongue and cheeks (cyanosis)
• Cough
• Swelling (edema) of the lower legs, ankles, feet, belly (abdomen), liver, or neck veins

The symptoms of heart murmur can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How are Heart Murmurs Diagnosed in a Child?
Your healthcare provider will ask about your child’s symptoms and health history and will give your child a physical exam. During an exam, the provider will listen to your child’s heart with a stethoscope. If the provider hears an abnormal sound, he or she may refer you to a pediatric cardiologist, a doctor with special training to treat children with heart problems. Tests to confirm the diagnosis may include:

• Chest X-ray. An X-ray creates images of the heart and lungs.
• Electrocardiogram (ECG). This test that measures the electrical activity of the heart.
• Echocardiography (echo). An exam that uses sound waves (ultrasound) to look at the structure and function of the heart. This is one of the most important test to find heart murmurs.

How are Heart Murmurs Treated in a Child?
Remember, a murmur is not a disease and it is not an indication that your child needs heart surgery. Most kids with murmurs have healthy, normal hearts.  However, if the murmur is from a congenital heart defect, treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is and may include medicine, procedures, or surgery. If the murmur is from another condition, the heart murmur will usually lessen or go away once the condition is treated.

Key Takeaways about Heart Murmurs in Children:

• Heart murmurs are extra or unusual sounds made by blood moving through the heart.
• Most heart murmurs are harmless.
• Some heart murmurs are caused by congenital heart defects or other conditions.
• The healthcare provider hears a heart murmur when listening to your child’s chest with a stethoscope.

Dr. Michael Brumund specializes in Fetal and Pediatric Cardiology, Adult Congenital Cardiology and Cardiac Intensive Care at Children’s Hospital. He has more than 17 years of experience in caring for children and adults affected by congenital heart disease. Dr. Brumund received his medical degree, residency training and fellowship in Pediatric Cardiology all from the Medical College of Georgia in Augusta, Georgia. Dr. Brumund is board-certified in Pediatrics and Pediatric Cardiology by the American Board of Pediatrics and in Adult Congenital Cardiology by the American Board of Internal Medicine.   He is one of only four adult congenital cardiology board certified specialists in the state of Louisiana.  He serves as an Associate Professor of Clinical Pediatrics at LSU Health New Orleans and is the Director of Outpatient Cardiology and Adult Congenital Cardiology.  When asked why he chose to specialize in Congenital Cardiology, Dr. Brumund said, “I take a very personal interest in all my patients and their families from fetus to the adult. The practice of congenital cardiology is very unique and provides me the opportunity to care for patients before they are born, in the newborn period, throughout childhood and then into adulthood.” Dr. Brumund sees patients at the Children’s Hospital Main Campus, Children’s Hospital Denham Springs Center and the Children’s Hospital Northshore Center.