Diagnosing and treating heart murmurs
Most heart murmurs require no special treatment other than leading a healthy lifestyle in general - not smoking, reducing stress, eating wisely and exercising regularly. Valvular defects can sometimes be treated medically; however, if the valve is severely diseased or defective, surgery may be recommended to replace the damaged valve(s).
Valvular defects refer to abnormalities of the valves that keep blood from flowing "backwards" into the heart chambers. A defective valve may allow blood to back up in the wrong direction or it may block the passage of blood, thereby interrupting the normal flow.
The production of murmurs is due to three main factors: (1) high blood flow rate through normal or abnormal orifices; (2) forward flow through a narrowed or irregular orifice into a dilated vessel or chamber; or (3) backward or regurgitant flow through an incompetent valve, septal defect, or patent ductus arteriosus (abnormal opening between the aorta and pulmonary artery).
A heart murmur may have no pathological significance or may be an important clue to the presence of valvular, congenital, or other structural abnormalities of the heart. Most systolic heart murmurs do not signify cardiac disease, and many are related to physiological increases in blood flow velocity.
In other instances, a heart murmur may be an important clue to the diagnosis of undetected cardiac disease (eg, valvular aortic stenosis). In these situations, various noninvasive or invasive cardiac tests may be necessary to establish a firm diangnosis. Two-dimensional (2-D) and Doppler echocardiography is particularly useful in this regard.
An important consideration in a patient with a cardiac murmur is the presence or absence of symptoms. For example, symptoms of syncope (passing out), angina pectoris (chest discomfort), or congestive heart failure in a patient with a midsystolic murmur will usually result in a more aggressive approach. A history of thromboembolism or possible infective endocarditis will also usually result in a more extensive workup.
Source: National Institutes of Health
Read what Jeanine Swenson, M.D., a pediatric cardiologist with Advanced Healthcare, says about heart murmurs in children.
