Heart murmur in kids

Heart murmurs are very common in babies and young children. In the vast majority of heart murmur cases, the heart is working normally and there isn’t anything to worry about. In fact many young children have heart murmurs and neither they nor their parents will ever know anything about it as many murmurs are innocent murmurs. A heart murmur is an extra or unusual sound made by the heart as the blood flows through any of the heart’s chambers or valves. It is usually the sound of the blood negotiating its way around the tight bends inside a young child’s heart and resembles a “whooshing” or “swishing” noise. It makes a sound like water rushing through a pipe. Blood has to negotiate two tight bends as it flows through the heart. The flow of blood traveling through the heart and blood vessels in this way can also make a noise, and this is known as an ‘innocent’ murmur. Innocent murmurs can sometimes come and go, becoming noisier if the heart is beating fast – after exercise or with a fever – and quieter as a child sleeps.

Heart murmur is an extra sound that is heard in addition to the normal heart sounds which are heard when the doctor listens to the heart with a stethoscope.

Types of heart murmurs include:

• Systolic murmur. A heart murmur that occurs when the heart contracts.
• Diastolic murmur. A heart murmur that occurs when the heart relaxes.
• Continuous murmur. A heart murmur that occurs throughout. the heartbeat.

Occasionally though, a heart murmur can be linked to a problem with the way that blood flows through the heart or a structural problem with the heart. Even if an underlying problem is the reason for a baby’s heart murmur, there is treatment available. A heart murmur very rarely proves fatal.

Heart murmurs in children key points

• Heart murmurs are extra or unusual sounds made by turbulent blood flowing through the heart.
• Many heart murmurs are harmless (innocent).
• Some heart murmurs are caused by congenital heart defects or other conditions. These are called pathologic.
• If the healthcare provider hears a heart murmur when listening to your child’s chest with a stethoscope, he or she may refer you a pediatric cardiologist for more tests.

Does having a heart murmur mean that my baby/child has a heart problem?

About one out of 100 babies is born with a structural heart problem also known as congenital heart defect, so most heart murmurs are not caused by heart problems. The most common types of heart murmur are called functional or innocent murmurs. This means the heart murmur is produced by a normal, healthy heart. These types of murmur can come and go throughout childhood. They usually go away on their own as the child gets older and don’t pose any health threat.

How do I know whether a heart murmur is a sign of a heart problem?

Your baby’s doctor or pediatric cardiologist will ask you questions about whether your baby is feeding well or whether she/he gets tired while feeding. They will also examine your baby carefully and listen to your baby’s heart using a stethoscope. Following the examinations if your baby’s doctor or pediatric cardiologist thinks there may be a problem with your baby’s heart they will arrange for your baby to have an echocardiogram (ultrasound scan of the heart). This takes a special moving image of the heart’s chambers and the flow of the blood; records the size and shape of the heart’s chambers, valves, and vessels; and shows the direction of the blood flow within the heart to help determine how efficiently the heart is pumping.

What are possible complications of heart murmurs in a child?

A heart murmur has no complications. But your child may have complications related to the condition causing the heart murmur. A child with a congenital heart defect may have poor growth and development, heart failure, or other serious problems.

Heart murmur in babies causes

Young children have small, slim chests so their hearts are nearer to a stethoscope than those of teenagers and adults, and their heart rate is faster. It is common for newborn babies to have heart murmurs in the first few days of life. When babies are in the womb they get oxygen from the placenta (afterbirth). After they are born they start to breathe and get oxygen from their lungs. Two of these connections which were in use when baby was in the womb should start to close immediately after the birth. It may however take a few days to a few weeks for this to complete. Sometimes
the murmur which can be heard is blood passing through these “old” connections.

Another type of murmur can sometimes be heard as blood passes through the blood vessels to the lung. These blood vessels can be narrow in newborn babies. As the baby grows, the heart rate slows, the heart grows and lies deeper within the body and the blood vessels also grow. The normal bends within the heart become less tight and an innocent murmur therefore disappears.

These heart murmurs are called innocent murmurs. In most cases, an innocent murmur disappears as a child gets older and the bends within the heart become less tight.

In rarer cases, a heart murmur can be a sign of a problem within the heart, a heart murmur can come from abnormal blood flow within the heart and blood vessels. This might be related to either a narrow or leaking valves in the heart, a narrow blood vessel or a hole in the wall between the two chambers of the heart or between the two main arteries of the heart. These heart murmurs may be called pathologic murmur.

Other causes of heart murmurs include:

• Infection
• Fever
• Low red blood cell count (anemia)
• Overactive thyroid gland (hyperthyroidism)

Heart murmur in babies symptoms

Children with innocent heart murmurs have no outward signs or symptoms. Its presence is usually only detected during a routine doctor’s examination.

A child with a pathologic heart murmur may have one or more of the following symptoms:

• Poor feeding, eating, or weight gain
• Shortness of breath or breathing fast
• Sweating
• Chest pain
• Dizziness or fainting (syncope)
• Bluish skin, especially of the lips and fingertips
• Cough
• Swelling (edema) of the lower legs, ankles, feet, belly (abdomen), liver, or neck veins

The symptoms of heart murmur can be like other health conditions. Have your child see his or her healthcare provider for a diagnosis.

Heart murmurs are graded on a scale of 1 to 6, based on how loud they are. One means a very faint murmur. Six means a murmur that’s very loud.

Heart murmur in babies diagnosis

Your child’s healthcare provider will ask about your child’s symptoms and health history. He or she will do a physical exam on your child. During an exam, your child’s doctor will listen to your child’s heart with a stethoscope. In this way, the doctor will be able to detect the presence of a heart murmur. If your child’s doctor hears an abnormal sound, he or she may refer you to a pediatric cardiologist. This is a doctor with special training to treat children with heart problems. Following the examinations if pediatric cardiologist thinks there may be a problem with your baby’s heart they will arrange for your baby to have these tests:

• Chest X-ray. An X-ray creates images of the heart and lungs.
• Electrocardiogram (ECG). This test that measures the electrical activity of the heart.
• Echocardiography (echocardiogram). An exam that uses sound waves (ultrasound) to look at the structure and function of the heart. This is the most important test to find heart murmurs.

Heart murmur in babies treatment

Some heart murmurs are clearly ‘innocent’ heart murmurs in children with strong, healthy hearts when heard through a stethoscope. If the heart murmur is innocent, no follow-up or treatment is needed.

If the quality of the heart murmur suggests that it might be due to some sort of structural abnormality, the cause of the murmur needs to be established. Even then, most heart murmurs are not signs of a serious heart problem in children with no other symptoms.

A child might be referred to a heart specialist (pediatric cardiologist) for a thorough examination and possibly further investigations. For instance an echocardiogram (an ultrasound scan of the heart) might be recommended.

This scan is designed to show the structure, function and blood flow of the heart, and will aim to rule out any underlying problem.

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the underlying condition is.

If the murmur is from a congenital heart defect, treatment may include medicine, procedures, or surgery. If the murmur is from another condition, the heart murmur will usually lessen or go away once the condition is treated.