HEART MURMUR OVERVIEW

Lub-dub. Lub-dub. Lub-dub. If you have ever put your ear up to someone's chest or have used a stethoscope, you know that's what the heart sounds like. These sounds correspond to specific events in the heart — the closing of certain valves. In fact, the sounds the heart makes can serve as clues about the health of the heart because the sounds can change with certain heart conditions. A murmur, for example, is a sound the heart may make that sometimes signals disease. It may sound like a blowing or rumbling noise.

Most murmurs are "innocent," meaning that they occur when there is nothing wrong with the heart. But some murmurs do indicate a problem, such as valve disease or birth defects. For example, a murmur can indicate that a heart valve is not closing or opening properly. If a valve stays partly open when it should be closed, a murmur may indicate that blood is leaking backwards. On the other hand, if a valve is not opening fully, a murmur may indicate that blood is passing through a narrowed space.

Some valve disease is present from birth (congenital) and may change with time; some valve disease develops with aging and disease, such as infection. Any of the four heart valves (aortic, mitral, pulmonic, tricuspid) may be affected by disease (figure 1). Some examples of valve disease that can cause a murmur are aortic stenosis and mitral regurgitation. People with mitral regurgitation who have surgery to replace the valve need to take antibiotics in preparation for routine medical procedures.

Since most murmurs are innocent, many people who have murmurs do not need any additional testing. But if your doctor or nurse suspects you have a non-innocent murmur, he or she may recommend an echocardiogram, the most common test performed to evaluate murmurs. The test uses sound waves to create images of your heart as it beats. It allows your doctor to see whether there is anything amiss with your heart.

UPTODATE HEART MURMUR RESOURCES

Patient information — UpToDate has a number of articles for family members and patients living with a heart murmur. These articles are available on the internet at www.uptodate.com/patients.

  (see "Patient information: Mitral regurgitation")

  (see "Patient information: Antibiotics before procedures")

Premium subscription information — More detailed information is also available by subscription.

  (see "Clinical manifestations and diagnosis of patent ductus arteriosus")

  (see "Definition and diagnosis of mitral valve prolapse")

  (see "Etiology, clinical features, and evaluation of chronic mitral regurgitation")

  (see "Pathophysiology and clinical features of atrial septal defects in adults")

  (see "Pathophysiology and clinical features of chronic aortic regurgitation in adults")

  (see "Pathophysiology and clinical features of mitral stenosis")

  (see "Pathophysiology and clinical features of valvular aortic stenosis in adults")

  (see "Pathophysiology; clinical features; and diagnosis of tetralogy of Fallot")

  (see "Pathophysiology, clinical features, and management of acute mitral regurgitation")

  (see "Etiology, clinical features, and evaluation of tricuspid regurgitation")

  (see "Aortic valve sclerosis")

  (see "Noncardiac surgery in patients with aortic stenosis")

  (see "Noncardiac surgery in patients with mitral or aortic regurgitation")