Heart murmurs in adults
In adults, heart murmurs are most common due to valve defects. The medical profession differentiates between stenosis and insufficiency. Valve stenosis is a narrowing or almost complete closure of a valve, while insufficiency is an incomplete closure of the valve with subsequent blood return when the heart muscle contracts.
Depending on the heart valve and valve defect, the sound occurs in systole or diastole. The most common valve defects are aortic stenosis and mitral valve insufficiency. In aortic stenosis, the valve between the heart (left chamber) and the aorta (main artery) no longer opens completely, causing a systolic heart murmur.
As a result, the heart has to exert more force to transport the blood from the heart into the large circulation. Initially, this force can be applied, but over time the heart loses function and symptoms of failure may occur. An important late symptom is dizziness or unconsciousness due to the undersupply of blood to the brain.
In mitral valve insufficiency, the valve between the pulmonary circulation and the heart (left atrium) no longer closes completely, which also causes a systolic heart murmur. The backflow of blood during the contraction (tension) of the heart muscle can lead to congestion back into the lungs and the consequent accumulation of water in the lungs (pulmonary edema). The consequences are respiratory problems and increasing shortness of breath.
It is possible to distinguish between the two heart murmurs, although they occur simultaneously, namely in systole. Aortic stenosis can be heard with a stethoscope most likely on the right side of the sternum, below the 2nd rib. Mitral regurgitation is most loudly heard to the left of the sternum, between the 4th and 5th rib.
Heart murmurs in the ear
Noises in the ear are usually referred to in medicine as tinnitus. Tinnitus is usually a permanent noise in the ear, usually whistling or whistling. If a patient reports a heart murmur in the ear – a so-called pulsatile tinnitus – the attending physician should become aware of it.
A noise in the ear, which is related to the heartbeat of the affected person, most likely has a diagnosable cause in the area of the vascular supply in the head. This can be a pathological change or a standard variation of the vessels. In this case, the changes affect vessels that supply the head with blood.
Typical arterial changes are connections between arteries and veins, aneurysms, bleeding between the wall layers (dissection) and vascular calcification with subsequent vascular occlusion. The venous system can be affected by thromboses or also by wall sacculations (ectasia). A tumor should also be excluded at the time of diagnosis.
Especially vascular neoplasms near the auditory canal or tumors that constrict certain vessels can trigger pulsatile tinnitus. Other possible causes are high blood pressure in the head, anaemia and a fundamental increase in heart work due to hyperthyroidism or pregnancy. The cause of the ringing in the ears must be treated depending on the patient’s level of suffering and the risk of consequential damage.
Due to the constant noises in the ear, many affected people cannot sleep well anymore, which can have a massive impact on the quality of life. Vascular damage in the head can lead to life-threatening bleeding, which must be prevented in any case.
