Heart Murmur: Causes, Characteristics & Treatment

What is a Heart Murmur?

As the name suggests, a heart murmur refers to irregular sounds in the heartbeat cycle. This condition causes the heart to make swishing or whooshing sounds as it beats. The sound results from irregular blood turbulence in the heart. Doctors usually use a stethoscope to listen to the heart for murmurs. A healthy heart makes consistent, two-part thumping sounds when the heart valves open and close, but a murmur interrupts the pattern.

Like other cardiac disorders, patients may have a heart murmur from birth or they may develop the symptom later in life. On its own, it may not be a cause for concern. However, it may signal a more serious underlying medical condition. A heart murmur is often the first sign that a patient has another condition that affects the heart valves.

Characteristics of Heart Murmurs

Innocent Heart Murmurs

With this type of heart murmur, patients have a healthy, normal-functioning heart. But blood flows through the heart faster than normal, making a different sound than a normal heartbeat. Innocent heart murmurs are also called functional or physiologic murmurs. They are common in infants and children, but they usually disappear by the time they reach adulthood. There is no underlying health condition.

Abnormal Heart Murmurs

This type is more serious. Usually, they are the result of congenital heart disease in children or acquired heart valve problems in adults. An innocent heart murmur does not cause any other symptoms, but an abnormal heart murmur may have an underlying heart problem that does cause symptoms:

• Rapid breathing
• Difficulty feeding (in children)
• Weight gain
• Blue lips or fingertips
• Failure to thrive
• Fatigue
• Dizziness or fainting
• Swelling in the legs, ankles, feet, liver, neck veins or stomach
• Difficulty with exercise or physical activity
• Chest pain
• Shortness of breath

Measuring Heart Murmurs

Doctors use a stethoscope to examine heart murmurs by assessing the heart’s timing, duration, tonal quality and pitch. There are two main types: systolic and diastolic. In a systolic heart murmur, the swishing sound occurs between the first and second sound. On the other hand, diastolic murmurs happen after the second sound.

Doctors describe the timing as early systolic, mid-systolic or late systolic. Duration refers to how long the abnormal sounds occur between heartbeats. For instance, holosystolic murmurs occur throughout systole. Heart murmurs can also be described using pitch — low, medium or high.

There are various classifications to describe the shape of a heart murmur, including crescendo and decrescendo. The former refers to a heart murmur that increases in intensity, while the latter describes one that decreases in intensity.

Causes of Heart Murmurs

Innocent Heart Murmurs

Innocent heart murmurs occur when blood moves much more rapidly through the heart than normally. They occur without any underlying medical condition. Innocent murmurs may be caused by:

• Pregnancy
• Intense physical activity
• Infection
• Fever
• Anemia
• Hyperthyroidism

Innocent heart murmurs may disappear over time or they may last an entire lifetime without causing any adverse health effects. However, abnormal heart murmurs are associated with another condition.

Congenital Heart Defects

One common cause of heart murmurs in babies and children is congenital heart defects or problems with the structure of the heart. Congenital defects are present at birth.

Septal Defects

In a septal defect, the patient has a hole between the right and left sides of the heart (x). The severity depends on their size and location. It causes abnormalities in blood flow between the heart chambers and heart vessels, causing irregular sounds in heartbeat.

Patent Ductus Arteriosus

Before birth, a fetus’ heart has a channel called a ductus arteriosus. The channel links the pulmonary artery and the aorta, which enables blood to bypass the lungs because the fetus does not breathe yet. However, the channel usually closes after birth and the infant starts breathing on its own. In some cases, the ductus arteriosus does not close and continues to function after birth, causing abnormal blood flow.

Heart Valve Abnormalities

Even though these abnormalities are present at birth, they may not be discovered until later in life. An example of a congenital heart valve abnormality is aortic valve stenosis, a condition that causes constricted valves that do not let enough blood through them. In other cases, the heart valves may not close correctly and then leak blood. This condition is called regurgitation.

Aortic Valve Calcification

As patients age, calcium may accumulate on the heart valves, causing them to thicken. Thickened valves are more narrow and make it difficult for blood to flow through, causing heart murmurs.

Endocarditis

Patients may also have heart murmurs from an infection on the inner lining of the heart or valve, called endocarditis. The infection may develop from bacteria or other microorganisms that travel from other parts of the body — such as the mouth — and into the heart. Untreated, the infection can damage the heart valves.

Rheumatic Fever

Although this condition is rare, it may occur in patients who do not seek quick medical attention for strep throat infection. Rheumatic fever that spreads to the heart can cause permanent damage to the heart valves and interfere with normal blood flow in the heart, which can trigger heart murmurs.

Cardiac Myxoma

Rarely, benign non-cancerous tumors can grow inside the heart and obstruct blood flow. This condition often leads to a heart murmur.

Risk Factors for Heart Murmurs

Family History of Cardiac Disorders

According to research, the likelihood of a heart murmur increases if a patient’s relatives exhibit a history of cardiac disorders.

Underlying Health Conditions

Other medical conditions may elevate the risk of an abnormal heart murmur. For example, hypertension, hyperthyroidism, carcinoid syndrome, rheumatoid arthritis and systemic lupus may trigger a heart murmur.

Pregnancy

An infant is more likely to have a heart murmur after birth if the mother had a medical illness during pregnancy, such as rubella (German measles) or diabetes. In addition, taking certain medications, drinking alcohol and using illicit drugs during pregnancy can increase the risk of congenital cardiac defects.

Diagnosing Heart Murmurs

Physicians diagnose a heart murmur with a physical exam. The doctor uses a stethoscope to listen to the heartbeat, measuring the murmur’s volume, pitch, location, timing and length. This way, the physician can identify if the murmur is innocent or abnormal and if the patient has any other signs of heart problems. However, in some cases the patient may need additional tests to gather more information. Other diagnostic tests include an electrocardiogram, chest X-rays, echocardiogram and cardiac catheterization.

Treating & Preventing Heart Murmurs

Treatment for a heart murmur depends on the underlying cause. If the condition is innocent, the patient does not require treatment because it is not associated with any health condition. The patient has a normal heart structure and the symptom does not raise any concerns. It may even disappear on its own.

The murmur itself does not need treatment. However, if it signals another heart condition, the patient may require treatment for that, depending on the cause and any other symptoms. Treatment options include surgery, medication or a valve replacement procedure.

Medication

Depending on the condition that causes the heart murmur, a doctor may prescribe different medications. If the patient has high blood pressure, they may take ACE inhibitors or beta blockers to regulate it. Anticoagulants can help prevent blood clots and statins can help lower cholesterol and keep heart problems from getting worse. The patient may also take diuretics to eliminate excess water and salt from the body and make it easier for the heart to pump blood.

Surgery

If medications do not solve the problem on their own, the patient may need a surgical procedure to address the cause of the murmur. A doctor may perform an annuloplasty, balloon valvuloplasty, structural support repair or valve leaflet repair.

Valve Replacement

The patient may also need a valve replacement procedure, such as open heart surgery or transcatheter aortic valve replacement (TAVR). An open heart surgery removes the damaged valve and replaces it with an artificial one. The artificial valve is either made of metal or tissue from a human donor. However, TAVR is a less invasive procedure. The doctor makes an incision in a vein in the leg or the chest to install the artificial valve.

Supplements for Heart Health

In addition to medical treatment, patients may also increase and maintain heart health with dietary supplements. They may provide a number of benefits to cardio health. However, they are not a medical treatment and may not be safe for all patients. Always consult a doctor before taking supplements.

Magnesium 

Magnesium promotes oral and immune health, as well as cardiac health by regulating blood pressure. It may also be able to help prevent a congenital heart murmur by promoting healthy pregnancies. It can prevent eclamptic seizures and protect the heart from high blood pressure during pregnancy, which can cause serious complications. Medical researchers also state that magnesium can help treat an irregular heartbeat. The mineral supports a wide range of bodily reactions to keep the bones, heart, muscles and nerves healthy. Leafy vegetables, whole grains, nuts and yogurt are all rich in magnesium. However, sometimes people do not get enough of it through the diet, so supplements are another option.

The recommended dosage for magnesium citrate powder is 4,400 mg (1 ½ tsp) daily mixed with liquids. Consult a doctor for approval. Magnesium is generally safe in proper doses. However, side effects may include indigestion, nausea, vomiting, diarrhea and loss of appetite. It is likely safe for pregnancy and breastfeeding in smaller doses. It may not be safe for patients with bleeding disorders, kidney problems, heart block, immune diseases or inflammatory bowel disease.

Omega-3 Fatty Acids

Fatty acids make up the fat in the body and in food. There are several different types of fatty acids and omega 3-6-9 are three of them. Omega-3 fatty acids are responsible for lowering triglyceride levels. High triglyceride levels can increase the risk for heart disease. It can also help reduce inflammation in the body, which causes diseases like Alzheimer’s disease and arthritis. Omega-6 fatty acids can help reduce inflammation in rheumatoid arthritis and omega-9 fatty acids can help reduce cholesterol and lower blood pressure.

There are food sources that include fatty acids — walnuts, fatty fish, corn, eggs, avocado, olive oil — but supplements are also available to ensure a fixed, consistent dosage. The supplement contains a wide range of oils rich in essential fatty acids. It may promote cardiac health and help minimize inflammation in the body. Take three omega 3-6-9 softgels once or twice daily, with a doctor’s approval. However, some patients may develop side effects such as bloating, burping and upset stomach. Contact a doctor if it causes itching, swelling or a rash.

Vitamin D

This product promotes cardiac health by regulating the hormone that controls calcium consumption and absorption. Another significant benefit is its easy absorption into the body. Lack of vitamin D in the body is associated with various health complications, including osteomalacia and osteoporosis. In addition to calcium, it also helps the body absorb magnesium and supports metabolic processes with vitamin A.

Though it has many different benefits, vitamin D may be toxic in large amounts. Therefore, it’s important to carefully measure the right proportions. Avoid using this product without an accurate milligram scale. Overdose may cause irritability, irregular heartbeat, weight loss, nausea, constipation, seizures and weak muscles. The healthy serving portion for vitamin D3 supplements is 50 mg per day, unless a physician advises against it.

Coenzyme Q10 (COQ10) 

Coenzyme Q10 (COQ10) is a strong antioxidant that boosts energy levels and ensures cardiac health. It has a long history as a medical treatment for heart problems. COQ10 occurs in almost all cells in the body and rid the body of free radical damage. It may also help regulate blood pressure and benefit patients with heart failure, coronary heart disease and atherosclerosis, according to research.

Food sources include heart, liver, kidney, fish, dairy, nuts and seeds, cauliflower, broccoli and sweet potato. COQ10 is also available as a supplement. For best results, take this product in conjunction with a healthy diet and exercise for muscle, skin, bone, brain, immune and heart health (x). The recommended serving size for coenzyme Q10 (COQ10) powder is between 50 and 200 mg per day. Make sure to use an accurate milligram scale and always consult a doctor before taking this supplement.

L-Citrulline 

Athletes often use L-citrulline as a supplement to increase performance. However, it may also regulate blood pressure and strengthen the immune system. It reduces blood vessel dilation, which helps control blood flow and prevents excess pressure. Studies state that it may also help boost the immune system because it acts as a neutrophil, a type of white blood cell that fights infection. This may be beneficial for heart murmurs because they can develop from an infection.

The recommended dosage for L-citrulline powder is 3,000 mg (1 tsp) per day, unless a doctor recommends a different dosage. Most likely, this product does not cause adverse side effects in the correct dosage. However, patients who are pregnant or nursing should avoid this supplement and so should patients with a history of liver or kidney problems.

The Bottom Line

Heart murmurs are a symptom that causes a heart irregularity that makes swishing sounds between the regular two-part heartbeat. There are two types of heart murmurs: innocent and abnormal. The former occurs without any specific cause. They are common in infants and children and may disappear as the patient ages. On the other hand, the latter signals another problem in the heart. The murmur itself does not require treatment, but the underlying heart condition might.

There are various factors that may cause a heart murmur, including congenital heart defects, cardiac infections, high blood pressure, valve calcification or rheumatic fever. Some patients do not have any symptoms other than the murmur, but others may experience others. Common symptoms of a heart murmur include general weakness, fatigue, fainting, chest pain, shortness of breath and swelling in the body.

If the patient requires treatment, a doctor may prescribe medication or perform surgery or a valve replacement procedure. Dietary supplements may also help patients maintain a healthy cardiovascular system and avoid heart problems. However, they are not an effective medical cure on their own. But paired with other treatment options and a doctor’s permission, supplements may benefit a patient’s overall health.

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Created on Mar 4th 2020 15:59. Viewed 291 times.

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