Being told that you have a heart murmur can be scary, but most are not serious or cause for alarm. A cardiac murmur is simply a heart sound that is abnormal. The sound is created by blood flow moving through one of the valves of your heart. 

The heart has four valves, which when working normally, will help keep blood moving in the right direction and into your circulatory system. Sometimes, the valves do not close properly and can change the way that blood moves through the valve. This change in blood flow creates a “whooshing” sound that is called a murmur. An estimated 10% of adults have a heart murmur. 

What causes heart murmurs?

Heart murmurs can be congenital, meaning you have them from birth, or they can develop later in life. Heart murmurs can also be innocent or abnormal. A person with an innocent heart murmur has a normal heart and does not require treatment. A person with an abnormal heart murmur may need more extensive testing to determine the cause.

In adults, abnormal heart murmurs are mostly caused by acquired valve issues. Sometimes the valve flaps (also called leaflets) fail to close properly either due to stiffening, (which can happen as we age) or from valve disease, which changes how the leaflets fit together. Murmurs can also occur when the heart muscle weakens. Other causes of a heart murmur include congenital heart conditions, anemia, rapid growth and extreme physical exercise.

To assess your murmur your doctor will order an ultrasound of the heart, called and echocardiogram, to get a better understanding of the valves and chambers of your heart. 

The timing of a murmur is important to consider and helps your doctor decide what valve is causing the sound. Murmurs can be systolic, which means they occur when the heart contracts, or diastolic, which means they occur when the heart relaxes. The sounds can be further organized by how long they can be heard and by how loud they are.

How is a heart murmur diagnosed?

A heart murmur is usually detected when your doctor is listening to your heart through a stethoscope. If your doctor thinks your heart murmur is caused by a condition that needs treatment, he or she may order an echocardiogram and electrocardiograph and refer you to a cardiologist for further assessment. A CT scan and MRI may also be needed to find out more about your heart's structure.

Should I be worried?

Not necessarily. Many people will have a heart murmur their whole lives without needing treatment. Some murmurs, especially ones detected in children, are ‘innocent.’ This means that they will not affect your overall heart health and often go away with time. However, some murmurs, particularly those that occur from aortic valve abnormalities, require frequent monitoring. If your murmur is cause for concern, you may be referred to a cardiology specialist who will evaluate you to see if you are a candidate for replacement of the valve.

What can I do?

If you are diagnosed with a heart murmur, it is important to watch for symptoms such as difficulty exercising, extreme tiredness or shortness of breath. Daily exercise and a well-balanced diet are a great foundation for a healthy heart. If you have high blood pressure, work with your doctor to keep it in check. Any treatment you may need will depend on your condition and the symptoms you have.

You should inform your doctor if you experience any of these symptoms even if you've been told your murmur is innocent:

• Chest Pain
• Trouble doing usual activities/exercise
• Shortness of breath
• Sudden weight gain
• Ankle swelling
• Dizziness of fainting
• Extreme tiredness
• Fever or night sweats
• Any symptoms that are out of the ordinary and causing you concern