Conditions

Heart Murmur

Detailed anatomical model of the human heart, illustrating its chambers and valves

What That “Whoosh” in Your Chest Really Means: A Doctor’s Guide to Understanding Heart Murmurs

When I meet patients for the first time and place my stethoscope on their chest, I’m often listening for more than just the familiar “lub-dub.” Sometimes, I hear an extra sound—a soft whooshing or swishing noise. That sound is what we call a heart murmur, and while it might seem alarming, it doesn’t always mean there’s a problem.

What Is a Heart Murmur, Really?

A heart murmur isn’t a diagnosis—it’s a clue. It’s the sound of turbulent blood flow in the heart, picked up during a routine exam. Think of it like a gentle swirl in an otherwise smooth stream. Sometimes it’s harmless. Other times, it signals something deeper that needs our attention.

Why Do Heart Murmurs Happen?

Heart murmurs can be caused by many things—some completely benign, others linked to structural heart problems. Here are a few possibilities:

• Valve abnormalities: If a valve is too tight (stenosis) or too loose (regurgitation), blood doesn’t flow smoothly.
• Holes in the heart: Septal defects between chambers can create irregular flow.
• Increased blood flow: Conditions like pregnancy, fever, or an overactive thyroid can temporarily speed up circulation, leading to innocent murmurs.

Types of Heart Murmurs: Knowing the Difference

Innocent Murmurs
These are common in children and young adults. They often occur during growth spurts, pregnancy, or times of increased circulation. They don’t signal heart disease and typically go away on their own.

Abnormal Murmurs
These may point to congenital heart defects or acquired conditions such as valve disease. They require further evaluation and, sometimes, treatment.

When Do Murmurs Happen? Timing Matters

Doctors also classify murmurs based on when they occur in the heartbeat:

• Systolic murmurs – heard when the heart contracts
• Diastolic murmurs – heard when the heart relaxes and fills with blood

This timing, along with the sound’s quality, pitch, and location, helps determine the cause.

What Could an Abnormal Murmur Mean?

Some of the common underlying conditions include:

• Congenital heart defects – present from birth, like atrial or ventricular septal defects
• Valve disease – caused by age-related changes, infections (like endocarditis), or rheumatic fever
• Heart infections or damage – from conditions like myocarditis or structural deterioration

Symptoms That Should Raise Concern

Innocent murmurs are symptom-free. But abnormal murmurs may come with:

• Shortness of breath during activity or rest
• Chest pain or pressure
• Fainting or dizziness
• Bluish skin or lips (cyanosis)
• Poor weight gain in infants
• Swelling in the legs or feet
• Unexplained fatigue or sweating

If you or a loved one has these symptoms, it’s time to speak to a heart specialist.

How Do We Diagnose a Heart Murmur?

Heart murmurs are often first detected during a physical exam. But to understand the cause, we might use:

• Echocardiogram: An ultrasound to see your heart in action
• Electrocardiogram (ECG): Checks electrical activity
• Chest X-ray: Assesses heart size and lung condition
• Cardiac catheterization: Provides detailed pressure and flow information

Treatment: When and What’s Needed

• No treatment for innocent murmurs—just reassurance and routine checks
• Medications to manage symptoms or underlying heart disease
• Surgery or procedures to correct structural defects or repair/replace valves

The right approach depends entirely on the cause and severity.

Living with a Heart Murmur: What You Should Know

If you have an innocent murmur, there’s usually nothing you need to do. But if your murmur is tied to an underlying issue, maintaining a heart-healthy lifestyle is key:

• Follow-up with your cardiologist
• Eat a heart-smart diet
• Stay active (with guidance)
• Manage blood pressure, cholesterol, and blood sugar
• Avoid smoking and excess alcohol