Heart murmurs can occur in people of any age and in most cases indicate serious disease of the heart, heart valves or heart vessels. Treatment of heart murmurs depends on the underlying condition, so they can be a symptom of several heart problems. It is imperative that the cause of the heart murmurs be determined by an internal medicine specialist (cardiologist).
What are heart murmurs?
Since heart murmurs can be an indication of serious diseases of the heart, a more detailed clarification by a specialist is necessary in most cases. By heart murmurs, physicians mean altered sounds of the heart that indicate a pathological change of the heart, the heart valves or the vessels connected to the heart. The physician usually detects these heart murmurs when listening to the heart sounds with a stethoscope. Since heart murmurs can be an indication of serious diseases of the heart, a more detailed clarification by a specialist is necessary in most cases. The human heartbeat is divided into two phases called systole (ejection phase of the heart) and diastole (filling phase of the heart). Depending on which phase the heart murmurs are heard during, they are referred to as systolic or diastolic heart murmurs.
Causes
Heart murmurs can have very different causes and often indicate abnormal changes in the heart or a heart defect. Depending on the phase of the heart murmurs, different causes may be considered. Heart murmurs heard by the physician in the systolic phase can indicate various obstructions and occlusion disorders of the heart valves. Especially in children, adolescents and pregnant women, systolic heart murmurs may occur that have no pathological significance. Heart murmurs without pathological significance may also frequently occur during physical exertion. Diastolic heart murmurs always have a disease-related cause such as aortic insufficiency or stenosis of the vessels found in the area of the heart. If a patient suffers from heart murmurs in both phases, this usually indicates a more severe heart defect or a serious dysfunction of the heart. Because so many different causes are possible, accurate diagnosis of heart murmurs by a specialist is essential.
Diseases with this symptom
- Heart defect
- Endocarditis
- Aortic valve stenosis
- Stenosis
- Aortic valve regurgitation
- Heart valve failure
Diagnosis and course
To determine the cause of a heart murmur, the doctor first listens to the patient’s chest with the help of a stethoscope. He describes any heart murmur that may be occurring based on the loudness and the time at which he hears it, among other factors. If there is a suspicion of a serious underlying disease, the internal medicine specialist has various other diagnostic options at his disposal that enable him to reliably assess the heart murmurs. These include, for example, an ECG, an exercise ECG and an ultrasound of the heart, which provide information about the functioning and appearance of the organ. A cardiac catheterization can also be informative about the cause of heart murmurs.
Complications
Occurring heart murmurs can put the affected person in a life-threatening condition without medical evaluation. The heart murmurs may increase in intensity and occur more frequently. There is a threat of intermittent cardiac activity or chronicity of symptoms. Often, the murmurs cause anxiety in the affected person. The patient may begin to suffer from severe emotional distress as a result of the heart murmurs. In severe cases, an anxiety disorder or the onset of a panic attack may be triggered. The affected person suffers from the permanent threatening feeling that he could lose his life due to heart murmurs. He becomes restless, irritable and possibly hysterical. When treating the heart murmurs, any complications that occur must be assessed depending on the diagnosis. If the heart murmurs are attributed to excessive physical activity through sports or occupation, this can be a disruption to daily life. Changes must be made so as not to jeopardize the state of health.Taking medications can lead to preparation-specific side effects. These can stress other organs or have an effect on the psyche. In severe cases, surgery must be performed. The risks and side effects of surgery must then be considered. In most cases, further therapies follow and the administration of medication continues. A necessary change in the current lifestyle is often advised here as well.
When should one go to the doctor?
Unusual heart murmurs almost always have something to do with a malfunction of the heart, which is why a visit to the doctor must always be made in this case. The specialists responsible for heart murmurs are internists and cardiologists. A heart murmur that requires treatment is not the well-known normal palpitations, but rather deviating noises of the heart. Patients do not always notice unusual heart murmurs themselves. Often it is the family doctor who notices them when listening to the patient. This can happen as part of a routine examination or an examination for another illness, but also during a visit to the doctor because of heart problems. Heart murmurs occur when the heart is abnormally altered. This usually involves defects in the heart vessels or heart valves. Heart defects occur in a wide variety of forms. The main focus is on narrowed heart vessels and heart valves that do not close completely. Doctors distinguish between systolic and diastolic heart murmurs. While systolic murmurs do not always have a pathological background, diastolic murmurs are always related to a serious heart disease. To clarify heart murmurs, the internist or cardiologist has various examination methods at his or her disposal, such as ECG, ultrasound or a cardiac catheterization. The treatment of heart murmurs is based on the findings obtained from these examinations.
Treatment and therapy
Depending on the underlying cause of the heart murmur, the internist will initiate appropriate treatment. If it is a harmless heart murmur in children, adolescents or pregnant women, it is usually waited and a later control appointment is made. However, especially in babies and young children, careful monitoring of heart murmurs is essential to prevent serious heart problems. If there is a problem with the heart valves, either wait or initiate appropriate treatment, depending on the severity. This may mean that the patient has to take medication, but it may also mean that surgery is necessary, during which the patient receives a new heart valve. In any case, if a heart murmur is present, a specialist in internal medicine (or/and cardiologist) should be consulted so that the severity of the condition and the required therapy can be optimally assessed. Depending on the severity of the underlying disease, treatment of heart murmurs may succeed better or worse.
Outlook and prognosis
With the exception of harmless heart murmurs in children and adolescents, which may occur occasionally and then disappear, the murmurs usually indicate congenital or acquired heart defects. Depending on the type and intensity of the murmurs and on their occurrence during the systolic contraction phase or diastolic relaxation phase of the chambers, conclusions can be drawn about valvular defects or functional limitations in the main blood vessels connected to the heart. The outlook and prognosis for heart murmurs are closely related to the development of the causative heart disease. The heart murmurs themselves are always expressions of flow sounds caused by blood passing through the valve orifices, flowing into the atria, and being squeezed out of the ventricles. This also includes flow murmurs caused, for example, by possible backflow through valves that are not properly closed. In most cases of murmurs, which are manifestations of serious heart disease and may indicate decreased efficiency of the heart’s pumping action, the outlook and prognosis are unfavorable if the underlying disease is not treated. However, if the underlying disease is treated successfully, the heart murmurs will disappear by themselves or other murmurs will develop, which are caused, for example, by the endoprosthetic insertion of an artificial heart valve and must be considered normal in this case.
Prevention
To prevent the development of heart murmurs, a healthy lifestyle with plenty of exercise is recommended. Regular check-ups with the doctor provide early information about any heart problems. Especially in the case of babies and children, it is essential to attend the check-ups with the pediatrician, as he or she always checks the child’s heart tones for any heart murmurs.
What you can do yourself
Heart murmurs should always be clarified by the family doctor or cardiologist. Accompanying the medical examination, various measures and home remedies can be applied. First, it is important to reduce the stress on the heart and circulation by maintaining a healthy lifestyle. Affected persons usually suffer from a weakened heart and should therefore take care to take it easy. Strenuous activities should be avoided until the cause of the heart murmurs has been clarified. Noises that are loudest below the collarbone (machine sounds) indicate an open ductus arteriousus and require medical clarification. If a systolic or diastolic murmur is suspected, a patient diary should be kept, recording the nature and intensity of the murmurs and any accompanying symptoms. Heart murmurs such as thumping or rumbling do not have to be pathological. Sometimes relaxing the body through sleep and stress avoidance is enough to resolve the murmurs. Heart murmurs resulting from palpitations can be relieved by deep breathing and the Valsalva maneuver. The home remedy hawthorn strengthens heart muscle contractions and supports blood flow, while magnesium regulates heart rhythm and improves nervous system function. Generally, however, all types of heart murmurs should be evaluated by a physician.
