Heart murmurs are audible sounds, similar to swishing or whooshing, that arise when the blood flow through the heart is uneven, fast, or turbulent. They can manifest in adulthood or be present since birth. Innocent murmurs are pretty common and can arise in healthy people. However, certain heart murmurs may be indicative of severe heart conditions. Hence, obtaining a diagnosis and appropriate treatment based on the underlying cause is crucial.

Types
Experts have classified heart murmurs into mainly three types, according to the stage of the heartbeat the sound is heard:

• Diastolic murmur: The whooshing sound occurs when the heart muscle relaxes, and the blood enters the lower chambers of the heart
• Systolic murmur: The sound takes place along with the contraction of the heart muscles
• Continuous murmur: The sound can be heard throughout the entire duration of the heartbeat as it pumps and relaxes.

Causes
A heart murmur results from a choppy, turbulent, and rapid blood flow through the heart. This can happen when the heart empties or fills up with blood. Some of the causes of heart murmur might include the following:

• Pregnancy
• Fever
• Hyperthyroidism (an overactive thyroid)
• Lesser or no healthy red blood cells for carrying oxygen to the body tissues, manifesting as anemia
• Rapid growth phases like adolescence
• Exercise or physical activity

Some causes depend on their congenital or acquired existence. The congenital causes include

• Holes in the heart (like ventricular septal defect or atrial septal defect)
• Cardiac shunts

Acquired causes for heart murmurs emerging from heart valve damage later in life include:

• Calcium deposits
• Inner heart valves and lining infection or endocarditis
• Rheumatic fever
• Various underlying medical conditions can also bring about heart murmurs

Symptoms
Symptoms of heart murmurs depend on if they are innocent or worrisome. Innocent ones generally do not have any other indications other than the sound. However, in worrisome heart murmurs, patients may experience symptoms like:

• Dizziness
• Chest pain
• A blue or gray tinge on lips or fingertips
• Bluish skin
• Persistent cough
• Swollen neck veins and liver
• Fainting
• Shortness of breath
• A sudden increase in weight or general swelling
• Tightness or pain in the chest
• Palpitations
• Swollen abdomen or legs
• Profuse sweating even after little or no exercise
• Weakness

In infants, symptoms also manifest as a lack or slow pace of growth, along with poor appetite. In newborn babies, the signs of heart murmurs might be noticeable as:

• Stunted growth
• Issues in feeding
• The appearance of a bluish hue on the skin while engaging in any activity or while feeding
• Increased fussiness without any reason
• Difficulties in breathing

Treatment options
Most heart murmurs don’t need treatment as they don’t usually pose a real health risk. However, suppose your healthcare provider finds an underlying condition that could be concerning. In that case, they might recommend surgery or other therapies to slow down or correct the development of that specific condition. An echocardiogram or ECG, also known as the ultrasound of the heart or an ‘echo,’ is the first and most commonly used test. If there are any other worrying symptoms, further testing may be necessary.