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child with heart murmur

Heart Murmurs in Children: 5 Things to Know

When your doctor says there’s something wrong with your child’s heart, it can make your own stop. Instead of getting frightened, get informed. Here are 5 things to know about heart murmurs in children. 

A heart murmur is an extra sound in conjunction with the heartbeat. 

This might mean a whooshing or swishing sound occurs, almost like a gust of wind is blowing while the heart is beating. The sound itself is caused by turbulent blood moving around and through the heart valves. If the murmur occurs with the heart muscle’s contractions, it is a systolic murmur. If it occurs when the heart muscle relaxes instead, this is a diastolic murmur. Heart murmurs that carry on with no regard for contractions or relaxations are considered continuous murmurs. 

Some heart murmurs don’t cause any problems.

Heart murmurs are either innocent or abnormal. Innocent heart murmurs don’t cause any symptoms except for the sound accompanying the heart beat. Otherwise, the child is perfectly healthy and completely normal. No treatment is required, although your child may need to pay close attention as they age for any cardiac abnormalities that result. Abnormal, or pathologic, heart murmurs can be indicative of serious heart diseases. A child with an abnormal heart murmur will likely need to begin a heart healthy lifestyle at a very early age in conjunction with particular medications or other treatments to help stave off cardiac diseases. Eventually, surgery may be a necessity. 

If your child’s pediatrician hears a heart murmur, you’ll be referred to a pediatric cardiologist. 

Pediatric cardiologists are doctors who specialize in children’s hearts and cardiovascular system. The heart murmurs will be graded from 1 to 6 (quietest to loudest). Some cardiologists can successfully diagnosis normal or abnormal heart murmurs with more than 90% accuracy just by using a stethoscope. However, they may recommend radiographs (X-rays), electrocardiograms (ECGs), or echocardiograms (ECHOs) for improved accuracy. The X-ray will provide images of the heart and lungs. An ECG measures the heart’s electrical activity for normalcy, while an ECHO uses ultrasound technology to view the heart and is perhaps the most important part of diagnostic testing in heart murmurs. 

Most abnormal heart murmurs in children are caused by a congenital defect. 

A congenital defect is one present at birth. These might include a hole in the heart or an issue with a heart valve, such as stenosis (insufficient blood is passed through) or regurgitation (the valve doesn’t close like it should and winds up leaking). These issues can be present for quite some time before the murmur is noticed. Older children are more likely to have a heart murmur caused by progressive heart issues or other non-congenital causes, like infections. Rheumatic fever, a complication of improperly treated strep throat is rare in the United States but can cause a heart murmur by interfering with the heart valves. Other potential causes of murmurs include anxiety, thyroid conditions, fever, and anemia. 

Certain symptoms seen in tandem with a heart murmur can be indicative of the child having heart disease as well. 

This is one of the first questions your pediatric cardiologist will try to figure out. Symptoms of heart disease in infants include poor appetite and weight gain, sweating a lot, blue skin, difficulty breathing, and seeming frequently unwell. In older children, this may appear as difficulty exercising, swelling of the feet, crackling noises in the lungs, and a slow heartbeat among other things. RIsk factors for childhood heart disease include a family history, fetal rubella infection, Down’s syndrome, fetal alcohol syndrome, Noonan’s syndrome, Turner syndrome, and Marfan’s syndrome.

Last Updated: September 23, 2016