Lubb-dupp. Lubb-dupp. These are the onomatopoeic words often used by healthcare professionals to simulate the sound of a heartbeat. This rhythmic sound is produced by the opening and closing of the heart valves as blood circulates throughout the heart.
You may have come across the term “heart murmur.” A murmur is an additional sound detected by a stethoscope and can be described as a hum, ranging from faint to loud. It may be temporary or persistent, and can be present from birth or develop later in life due to factors such as pregnancy, rapid growth during adolescence, fever, or anemia.
A temporary murmur usually disappears quickly if it has a temporary cause. However, a persistent and loud murmur, resembling the sound of a churning mill wheel or a cooing seagull, could indicate a serious heart condition.
What causes a heart murmur?
There are multiple factors that can contribute to the development of a heart murmur, such as heart valve problems or a hole in the heart.
The heart valves act as doors between the different chambers, or rooms, of the heart. A murmur can occur when a valve is tight or leaky. When a valve is excessively tight or narrow, it is known as stenosis. Similarly, a leaky valve is referred to as regurgitation.
A murmur can also be caused by high blood flow in individuals with a fever or low red blood cell count, also known as anemia.
Some people may have a family history of heart murmurs and heart disease, while others may be born with a congenital condition that predisposes them to murmurs. Additionally, a recent severe infection or illness can potentially damage a heart valve, necessitating immediate medical attention.
What are the symptoms?
Innocent or harmless heart murmurs usually do not cause any noticeable symptoms, and most of them are not serious.
Symptoms associated with a serious heart murmur depend on the underlying cause and require evaluation by a healthcare professional. These symptoms may include:
— Bluish or grayish lips or fingernails
— Chest pain
— Fainting
— Fever
— Swelling in the legs
— Persistent cough
— Shortness of breath
— Sudden weight gain
— Swollen liver or neck veins
— Increasing fatigue
How is it diagnosed?
Heart murmurs are often detected during physical exams that are being conducted for other reasons. If a healthcare professional detects a murmur, they will inquire about your personal and family medical history to identify any potential causes.
Several criteria are used to determine whether a murmur is innocent or concerning. These criteria include:
— Volume: The loudness of the murmur is evaluated on a scale from 1 to 6, with 6 being the loudest.
— Location: The specific area of the heart where the murmur is heard is identified, as well as whether the sound radiates to the neck or back.
— Pitch: The murmur can have a high, medium, or low pitch.
— Timing: A murmur that occurs when blood leaves the heart is known as a systolic murmur, while a murmur that occurs when the heart fills with blood is called a diastolic murmur. A murmur that persists throughout the entire heartbeat cycle may indicate a more significant heart problem.
Further testing is required to determine the cause of the heart murmur. An echocardiogram, or echo, which is an ultrasound image of the heart’s valves, chambers, structure, and function, is commonly ordered by healthcare professionals to provide detailed images.
If the cause of the murmur is identified, some individuals may require ongoing evaluation, while others may require surgery to address issues such as tight or leaky valves or a hole in the heart.
In certain situations, individuals may need to take antibiotics before undergoing dental procedures to protect the heart valves from potential infection. This infection, known as endocarditis, can be transmitted through the bloodstream during dental work.
It is essential to determine whether a heart murmur is innocent or serious in order to receive appropriate treatment.
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Michel Barsoum, M.B., Ch.B., is a cardiologist and vascular medicine specialist affiliated with Mayo Clinic Health System in Chippewa Falls, Eau Claire, and Rice Lake, Wisconsin.
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