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Keeping Rhythm: The Basics of Heart Murmurs

February 18, 2020
Published in: Heart

Anatomical heart model

We all know the rhythmic thumping sound of a heartbeat. However, a heartbeat sounds differently in people with heart murmurs. It's estimated that 45% children and 10% of adults will experience a heart murmur at some point in their lives. Heart murmurs are common but can differ in severity, cause, and treatment.

A heart murmur is an abnormal sound of blood flowing between heartbeats. It usually sounds like a whooshing, swishing, or extra thumping sound. Heart murmurs are not classified as a disease. In fact, most heart murmurs normally harmless. However, in some instances a heart murmur can indicate a more serious heart condition.

Types of Heart Murmurs

There are two types of heart murmurs—innocent murmurs and abnormal murmurs. Innocent heart murmurs are often diagnosed in infants and children. They are not harmful and can even appear and disappear. When first discovered, some doctors will run additional tests to make sure the murmur is not an indication of a more serious condition. After being confirmed as an innocent heart murmur, most patients will not need any follow up care for the murmur.Woman holding a red heart

Abnormal heart murmurs are most often caused by defective heart valves. These defects can be caused by:
  • A hole in the heart
  • Infections
  • Cardiac shunts: abnormal blood flow between heart chambers or blood vessels
  • Stenosis: valves that don't allow enough blood flow
  • Regurgitation: valves that don't close properly and leak, sometimes called mitral valve prolapse
  • Valve calcification: hardened, thick, or narrow valves
  • Endocarditis: an infection of the lining of the heart
  • Rheumatic fever: a condition that occurs when strep throat is left untreated causing damage to heart valves


Heart murmurs, even abnormal ones, may not have noticeable symptoms. However, if you experience any of the following symptoms, it's important to consult your doctor. These symptoms can indicate a more serious heart condition:

  • Blue skin on your fingertips or lips
  • Swelling or sudden weight gain
  • Shortness of breath
  • Chronic cough
  • Enlarged liver
  • Enlarged neck veins
  • Poor appetite
  • Heavy sweating with minimal or no exertion
  • Chest pain
  • Dizziness
  • Fainting


A physical exam that includes listening to your heart with a stethoscope is the first part of diagnosing a heart murmur. The volume, pitch, sound, and location of the murmur helps your doctor diagnose it as innocent or abnormal. Additional tests such as an x-ray, electrocardiogram (ECG), echocardiogram, or a cardiac catheterization may also be part of the diagnosis process.

Doctor holding a plastic heartCare Plan

Innocent heart murmurs and many abnormal heart murmurs won't require treatment. If treatment is required, it is tailored to the specific type of heart murmur you have. Your doctor may prescribe medicine to prevent blood clots (anticoagulants), remove excess fluid (diuretics), lower your blood pressure (ACE inhibitors), lower your cholesterol (statins), or lower your heart rate and blood pressure (beta blockers). Some heart murmurs may require surgery to repair or replace faulty heart valves.

A heart murmur diagnosis doesn't have to cause undue stress. Heart murmurs are well understood and easily diagnosed by healthcare professionals. Most heart murmurs don't produce symptoms or require treatment. If you have any questions about heart murmurs, the team at Augusta Health Cardiology is ready to answer your questions.