When a heart murmur is heard during a physical exam, a doctor may perform tests to investigate the cause. The treatment plan will vary depending on the underlying cause of the murmur.
Diagnosing A Heart Murmur
The first test a physician will order is a chest x-ray. An x-ray can display the structures of the heart, lungs, and blood vessels. This is an easy test to perform and can show conditions like an enlarged heart, which may warrant further testing.
A second test is an electrocardiogram (ECG). The doctor places electrodes on the chest, and a monitor records the electrical activity of the heart. This can help to diagnose irregular heart rhythms and structural problems.
An echocardiogram is a test which uses sound waves to show detailed images of the heart and its function. This test can help to identify valves that have developed calcifications or valves that are not completely closing.
A cardiac catheterization is an invasive test in which a doctor introduces a catheter into a major artery or vein and measures the pressures in the heart. The doctor can also inject a dye into the vessel that can be seen on an x-ray and help to diagnose the conditions of the valves.
Treatments
An innocent murmur is a murmur in which no structural problems have been identified and is not causing any problems. In this case, the murmur will not need any treatment. A doctor will continue to monitor the patient periodically to ensure that no heart conditions develop. In children, an innocent murmur can develop after birth and eventually disappear as the child gets older.
Murmurs that develop from temporary conditions such as a fever or hyperthyroidism will usually disappear after the underlying condition is treated. If the murmur is caused by endocarditis (an infection in the heart), a course of intravenous antibiotics will be used.
In the case of other diseases that cause a heart murmur, medications may help to reduce the workload on the heart. A diuretic or water pill will help to reduce the amount of fluid in the body and can help to treat conditions like high blood pressure. The doctor can also prescribe a beta blocker to help the heart pump slower and more effectively.
When a murmur is caused by a valve problem and medication alone is not effective, surgery may be called for. One surgery used to treat a narrow or calcified valve is called a valvuloplasty. During this procedure, a small catheter is threaded through the heart to the valve, and a small balloon is inflated to widen the valve.
In the case of a leaking valve, a doctor can perform an annuloplasty. In this procedure, a surgeon implants an artificial ring around the valve to help the flaps of the valve to come together and allow for full closure.
If the valve has become so narrow that it needs to be replaced, then open heart surgery may be indicated. In this procedure, the valve can be replaced with a mechanical valve or a tissue valve. The mechanical valve is constructed of a sturdy metal, but it would require the use of anticoagulant therapy to prevent the formation of blood clots along the new valve. A tissue valve is donated from an animal or a deceased human donor. These valves will occasionally wear out and need to be replaced in the future.
