Heart murmurs are a relatively common finding in children. Many heart murmurs are harmless and do not signify any underlying heart problem. A heart murmur is simply a sound, and its presence prompts a careful evaluation to determine its cause and whether any action is needed.

What Is a Heart Murmur?

A heart murmur is an extra or unusual sound heard during a heartbeat. The typical heartbeat makes a “lub-dub” sound as the heart valves close. A murmur is a whooshing or swishing sound that can be heard between heartbeats. These sounds are generated by blood flowing through the heart’s chambers and valves.

Murmurs are categorized into two main types: innocent murmurs and worrisome murmurs. An innocent murmur is a harmless sound made by the normal flow of blood through a healthy heart. They are not a sign of heart disease and do not pose a health risk. They may become louder when a child has a fever, is anemic, or is physically active, because these conditions increase blood flow. Innocent murmurs do not require treatment and typically disappear as a child grows older.

A worrisome murmur indicates an underlying structural problem with the heart. Causes can include congenital heart defects, which are problems with the heart’s structure present at birth. Examples include septal defects or valve abnormalities. These types of murmurs require evaluation by a specialist.

What Are the Signs and How Is It Diagnosed?

Innocent heart murmurs do not cause any symptoms. A child with an innocent murmur will appear healthy, active, and have no issues with growth or development. The murmur is usually discovered incidentally during a routine physical examination when a doctor listens to the child’s heart with a stethoscope.

A worrisome murmur may be associated with signs of an underlying heart condition. Parents might observe the following in their child:

• Poor feeding or difficulty gaining weight in infants
• Bluish tint to the skin, lips, or fingernails
• Rapid or labored breathing
• Sweating
• Chest pain
• Dizziness or fainting spells

A doctor typically diagnoses a heart murmur by listening to the heart with a stethoscope. Based on the characteristics of the sound, the doctor can often determine if it is likely to be innocent. The cardiologist may perform several tests to get a detailed view of the heart’s structure and function. An echocardiogram, which is an ultrasound of the heart, is the most common and effective test. It provides images of the heart’s chambers, valves, and blood flow, allowing the doctor to identify any structural abnormalities.

How Are They Treated?

The treatment for a heart murmur depends entirely on its cause. Innocent heart murmurs require no treatment, medication, or lifestyle restrictions. A child with an innocent murmur can participate in all normal activities without any limitations. The doctor will continue to monitor the murmur during routine check-ups.

For worrisome murmurs, the treatment plan is tailored to the specific underlying heart defect. Some minor structural problems may not require immediate intervention and are simply monitored by the cardiologist over time. Other conditions may need active management. Treatment can range from medications to control symptoms or improve heart function to surgical procedures. The pediatric cardiology team will develop a comprehensive plan specific to the child’s condition.

Meet With a Cardiologist

The first step of learning about a murmur is to recognize that most murmurs are innocent and not a cause for alarm. If your pediatrician detects a murmur, a referral to a pediatric cardiologist is the standard course of action for a thorough evaluation. A consultation with a cardiologist will provide a definitive diagnosis and a clear path forward for treatment if needed.

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