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A heart murmur is an extra sound that the
blood makes as it flows through the heart. Your doctor uses a stethoscope to
listen to your heartbeat. When you have a heart murmur, your doctor can hear an
extra whooshing or swishing noise along with your heartbeat.
can be scary to learn that you or your child has a heart murmur. But heart
murmurs are very common, especially in children, and are usually harmless.
These normal murmurs are called "innocent" heart murmurs. There is nothing
wrong with your heart when you have an innocent murmur. Up to half of all
children have innocent murmurs.1 They usually go away
as children grow.
Adults can have innocent murmurs too. Innocent murmurs are often found in adults over 50 years of age. Murmurs also
happen when your blood flows harder and faster than usual—during pregnancy, for
example, or a temporary illness, such as a fever.1
Sometimes, though, a heart murmur is a sign of a
heart problem. This is called an abnormal heart murmur.
murmurs are signs of a heart problem. In children, abnormal heart murmurs are
usually caused by problems they are born with, such as a heart valve that
doesn't work right or a hole in the wall between two heart chambers.
In adults, abnormal murmurs are most often caused by damaged heart
valves. Heart valves operate like one-way gates, helping blood flow in one
direction between heart chambers as well as into and out of the heart. See a
blood flow through a normal heart.
When disease or an infection
damages a heart valve, it can cause scarring and can affect how well the valve
works. The valve may not be able to close properly, so blood can leak through.
Or the valve may become too narrow or stiff to let enough blood through. When a
damaged heart valve cannot close properly, the problem is called
regurgitation. When the valve can't let enough blood
through, the problem is called
Heart valves can be damaged by
heart disease or by infections like
rheumatic fever or
endocarditis. The normal wear and tear that comes with
aging can also cause some damage.
Some heart murmurs are caused by
a thicker than normal heart. When the heart muscle grows too large, it can get
in the way of normal blood flow and cause a murmur.
murmurs are found during regular doctor visits. During exams, doctors listen to
each part of the heartbeat, including any extra sounds, or murmurs, that may be
If a doctor hears a murmur, he or she can often tell
whether it is innocent by how loud the noise is, what part of the heart it is
coming from, and what kind of sound it is. He or she will also look for signs
of a heart problem—for example, shortness of breath when the person is active,
lightheadedness, a fast or irregular heartbeat, or a buildup of fluid in the
legs or lungs. If your doctor thinks your murmur may be a sign of a problem,
you will have tests to check your heart. You may also be sent to a heart
specialist, called a
cardiologist, for more tests.
If you have an innocent murmur,
you do not need treatment, because your heart is normal.
have an abnormal murmur, treatment depends on the heart problem that is causing
the murmur and may include medicines or surgery. Not all abnormal murmurs need
to be treated. If you have an abnormal murmur and have no other symptoms, your
doctor may only monitor your condition with an echocardiogram.
you have symptoms, you may need to take medicine to lower your blood pressure
and reduce your heart's workload. You may need surgery to replace a valve or
repair a heart defect.
heart murmurs are normal, and there is nothing you can
do to prevent them or cause them. They just happen.
murmurs cannot be prevented, either. They are often caused by infections or by
problems that run in families.
What you can
do is take good care of your heart by living a heart-healthy lifestyle. This includes eating healthy food and getting regular
exercise. Work with your doctor to control your blood pressure and your
cholesterol. And if you smoke, quit. Your doctor can help you quit your smoking
Visit the American Heart Association (AHA) website for information on
physical activity, diet, and various heart-related conditions. You can search for information on heart disease and stroke, share information with friends and family, and use tools to help you make heart-healthy goals and plans. Contact the AHA to find your
nearest local or state AHA group. The AHA provides brochures and information
about support groups and community programs, including Mended Hearts, a
nationwide organization whose members visit people with heart problems and
provide information and support.
This website is sponsored by the Nemours Foundation. It
has a wide range of information about children's health—from allergies and
diseases to normal growth and development (birth to adolescence). This website
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly emails about your area of interest.
The U.S. National Heart, Lung, and Blood Institute
(NHLBI) information center offers information and publications about preventing
Walsh RA, et al. (2011). The history, physical examination, and cardiac auscultation. In V Fuster et al., eds., Hurst's The Heart, 13th ed., vol. 1, pp. 239–306. New York: McGraw-Hill.
Other Works Consulted
Bonow RO, et al. (2008). 2008 Focused update incorporated into the ACC/AHA 2006 Guidelines for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing committee to revise the 1998 Guidelines for the management of patients with valvular heart disease). Circulation, 118(15):
Fang JC, O'Gara PT (2012). The history and physical examination: An evidence-based approach. In RO Bonow et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 1, pp. 107–125. Philadelphia: Saunders.
O'Gara PT, Loscalzo J (2012). Physical examination of the cardiovascular system. In DL Longo et al., eds., Harrison's Principles of Internal Medicine, 18th ed., vol. 2, pp. 1821–1830. New York: McGraw-Hill.
July 6, 2012
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology & George Philippides, MD - Cardiology
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