When I took our youngest daughter to her 18 month checkup, the pediatrician muttered something about a heart murmur as he listened at her chest with his stethoscope. My gasp probably led him to listen several more times and eventually let me know that it was considered a “benign” heart murmur. “We’ll just listen at every checkup”, he assured me.
Well, when the murmur is in your child’s heart, there is no such thing as benign. So I asked enough questions that he gave me a crash course in heart murmurs.
Essentially, a heart murmur is a sound made when the blood circulates through the heart. The murmur refers to an extra sound heard between the normal valve sounds. This extra sound can sometimes be a whoosh, or a rumble, a twang, or even a high-pitched squeak. Heart murmurs are graded on a scale of 1 to 6, a one being very faint, and a six sounding very loud.
The cause of a heart murmur is turbulent blood flow through the heart region, and there are several different conditions that cause the sounds, including:
Abnormal heart valve
Abnormal opening between two chambers of the heart
Narrowing of a major artery
Mitral valve prolapse (also known as aortic stenosis)
Heart murmurs fall into benign category or pathologic. Benign heart murmurs are also called functional heart murmurs or physiologic heart murmurs. As many as 9 out of 10 children may have a benign or function heart murmur. These benign murmurs are not usually associated with any other health conditions. Children with these heart murmurs have a healthy heart that just has an irregular flow of blood causing the murmur sound.
These types of murmurs are very common in children and many times are outgrown. Even when the condition persists in adulthood, most people lead healthy, productive lives and their hearts function in a normal way that doesn’t cause any problems.
Doctors listen for many things when they discover a murmur. They listen for exactly where in the heart the murmur is located; loudness or intensity using the 1 to 6 scale; the timing of the murmur, as in where it occurs in a heartbeat; and listening for the frequency or pitch of the murmur. Doctors will monitor this murmur to make sure that it hasn’t changed, and that the heart is still functioning properly.
A lot of times, the doctor may order an echocardiogram if he or she wants to do further testing. An echocardiogram is where a device is placed on the body over the heart and moved around to record a picture of the heart while it is pumping blood in and out of the chambers and valves. These tests are often ordered between the ages of 2 and 4. In more severe cases, a heart catheretization may need to be done to get additional information.
Our long-suffering and patient pediatrician ended by saying that most heart murmurs never require any treatment, just periodic evaluation. Parents shouldn’t be unduly concerned at hearing the words “benign heart murmur.” Any more serious heart function questions would be referred to a pediatric cardiologist.
So if you hear your pediatrician muttering about a murmur during your child’s next checkup, I hope this information is as comforting to you as it was helpful for me.
