What Is A Heart Murmur In A Newborn

Medications Used To Treat Abnormal Heart Murmurs

NEWBORN HEART MURMURS: What You Need to Know | Dr Paul
  • Anticoagulants/blood thinners

These help to thin the blood and work by preventing blood clots in heart and improving blood flow.

  • Diuretics/water pills

Water pills work by removing excess fluid from the body and are often used to treat conditions like high blood pressure, that are known to exacerbate heart murmurs.

  • Angiotensin-converting enzyme inhibitors

These also help to lower blood pressure.

  • Statins

These lower cholesterol. This is important for types of heart murmurs affected by high cholesterol.

  • Beta blockers

Beta blockers lower heart rate and blood pressure, reducing the risk of complications associated with these factors.

Surgery for heart murmurs caused by damaged valves

Damaged or leaky valves often won’t benefit from medication alone and your doctor may recommend one of the following surgeries.

  • Balloon valvuloplasty

Narrow valves may be treated by the insertion of a tiny balloon within the valve, which is then expanded to widen the valve.

  • Annuloplasty

When leaky valves are caused by abnormal openings, an artificial ring is inserted to ensure proper closure of valve flaps.

  • Valve flap/leaflet repair

In defective valves where the leak or blockage is caused by the flap itself, doctors will surgically separate, cut or pleat the valve.

  • Structural support repair

What Are Heart Murmurs In Children

Heart murmurs are extra or abnormal sounds made by turbulent blood flowing through the 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.

Types of 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.

Types Of Heart Murmurs

Innocent heart murmur

It’s estimated that a whopping 75% of all newborns experience innocent heart murmurs – so you’re definitely not alone!

Innocent heart murmurs do not require any treatment. This type of heart murmur may be present in hearts without any structural defects and, as the name suggests, is usually nothing to worry about. Innocent heart murmurs usually resolve themselves and are eventually outgrown or, in some cases, are present throughout life without causing any additional health problems/risks.

Innocent heart murmurs are often brought on by conditions that get the heart pumping, so to speak, by causing increased or rapid blood flow through the heart. Common causes of harmless heart murmurs are:

  • Pregnancy

  • Overactive thyroid

  • Growth spurts

While there is no treatment necessary for this type of heart murmur, underlying causes which may lead to ill health should still be treated.

Abnormal heart murmur

This type of heart murmur is more serious and requires special considerations and treatment. Abnormal heart murmurs are caused by congenital heart defects within the heart and may come with symptoms that are at times severe and debilitated.

Congenital heart defects that cause abnormal heart murmurs:

  • Holes in the heart

These may or may not be serious depending on size and position.

  • Abnormalities in the heart valves

The most common valve defects are: Stenosis – a condition in which blood has difficulty passing through the valves.


Valve calcification

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What Causes Heart Murmurs

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.

Blood has to negotiate two tight bends as it flows through the heart. The flow of blood travelling 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.

As the years go by, the heart rate slows and the heart grows and lies deeper within the body. The normal bends within the heart become less tight, and an innocent murmur therefore disappears.

In rarer cases, 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 valve, or a hole in the wall between the two chambers of the heart or between the two main arteries of the heart.

When To Worry About Heart Murmur In Infants

Heart Murmur Newborn Baby

Newborns are at a great risk of having congenital heart defects in fact, about 1% of newborns have a heart murmur, and about 31% to 86% of these newborns have structural heart disease. It is therefore a good idea to take your newborn or child to a pediatric cardiologist for further evaluation. Sometimes, potentially life-threatening heart defects are asymptomatic.

You should take your child to the doctor if you notice issues such as difficulty feeding, rapid breathing, failure to thrive, and blueness in the lips. Symptoms in older children may include chest pain, fatigue, and difficulty doing physical activity.

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Does Your Child Need To See A Doctor About Heart Murmur

Any problems with your babys heart are likely to be picked up at birth, when the midwife or paediatrician checks your baby. If problems arent detected then, theyll probably be picked up in checks during your babys first few weeks.

Sometimes heart murmurs are picked up during general check-ups or check-ups for other issues like infections.

Go to a hospital emergency department or call 000 for an ambulance straight away if your child is having trouble breathing, suddenly becomes pale or blue, or youre concerned your child is very unwell.

How The Heart Works

The normal heart has four chambers and four valves . The two lower pumping chambers of the heart are called the ventricles, and the two upper filling chambers are the atria .

Heres how blood moves in normal circulation:

  • Blood that returns from the body to the filling chamber on the right side is low in oxygen.
  • This blood passes across a valve to the pumping chamber on the right side and then travels across the pulmonary valve to the lungs to receive oxygen.
  • The oxygen-enriched blood returns to the filling chamber on the left side , then across a valve to the pumping chamber on the left side .
  • The blood is then pumped across the aortic valve out to the body through the aorta, a large blood vessel that carries blood to the smaller blood vessels in the body to deliver oxygen.

Using a stethoscope, a doctor examines the heart by listening to the sounds it makes. The familiar lub-dub sound of a normal heartbeat is caused by the closing sound of the valves as the heart squeezes to push blood through the body.

A heart murmur describes an extra sound in addition to the lub-dub. Sometimes these extra sounds are simply the sound of normal blood flow moving through a normal heart. Other times, a murmur may be a sign of a heart problem.

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When Does A Heart Murmur Go Away

Most often, the murmur will go away with age. However, some may live with a heart murmur into adulthood. In adults, meanwhile, some heart diseases including heart valve disease can cause heart murmurs. In this article, we describe the two types of heart murmur, their causes, and some treatment options.

Are Heart Murmurs Signs Of Something Else

Heart Murmurs: First With Kids – Vermont Children’s Hospital, Fletcher Allen

Mild heart murmurs, usually, do not signify anything abnormal. However, some cases can indicate a vessel or valve problem in the heart. Some children who show symptoms like a blue colouration of skin, feeding and breathing difficulties also exhibit heart murmur as a symptom of blood mixing due to cyanotic heart disease. A complete evaluation is usually done by the physician if he suspects any abnormality.

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Diagnosis Of Baby & Children Heart Murmur

The first step of diagnosis is to record the severity of the heart murmur by simply hearing it with a stethoscope. The sound is given a score from one to six and based on the score it is further taken for evaluation. The kind of sound, the timing of the murmur and other such things are also recorded. Sometimes, the doctor monitors the murmur over a period of time during regular checkups.

If the doctor suspects an underlying heart issue, he usually prescribes some evaluations like a chest X-ray, ECG or an echocardiogram. An echocardiogram is a scan of the various parts of the heart that can capture an abnormality in it.

My Child Has A Heart Murmur What Does That Mean

Imagine taking your 18-month-old child to see her pediatrician for her regular well-child visit. The doctor listens to her for an extended period of time looking somewhat concerned. He then turns to you and says, Has anyone told you that your child has a heart murmur? You tell him no, he then says, We need to send you to see a pediatric cardiologist. You ask what it means to have a heart murmur. He explains that a murmur is an extra noise, its probably nothing but it might be a hole in the heart or might be a heart valve problem, but that the cardiologist will explain it. The doctor finishes his well-child examination, you leave the office with a scheduled visit at the cardiology clinic in a week, and perhaps a sick feeling in your stomach.

This is a very common scenario in every pediatric cardiology clinic. A seemingly healthy child presents with a new finding and a concerned parent not sure what to make of the situation. A lot of the anxiety in this situation is produced by poor understanding of what is meant by a heart murmur.

Remember however, that the vast majority of heart murmurs are innocent and simply the sound made by normal blood flow. Understanding this should make any unexpected conversations about heart murmurs with your physician far easier.

Tags:cardiologychildrenechocardiogramheartheart murmurinfantsmurmurpediatrics

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What Are Heart Murmurs In Newborns

Many parents will be surprised to learn that a heart murmur isnt a disease. Rather, it is a symptom of an underlying condition. If your child has a heart murmur, your pediatrician will hear it while listening to your childs heartbeat with a stethoscope.

As the name implies, a heart murmur is an unusual sound produced by the heart in the course of its normal pumping action. Murmurs in children are relatively common and often do not signify any serious problem. The extra sounds might be nothing more than those of normal blood flowing through a healthy heart.

If a murmur is heard at birth, however, or during the first six months of life, your pediatrician might want to pursue further testing to rule out more serious congenital heart defects. Some murmurs are caused by , which occur when the walls separating the left and right sides of the heart have an abnormality that allows blood to mix. Murmurs can also signify underlying blood vessel disease.

A murmur is usually the only symptom of patent ductus arteriosus , a potentially serious condition in which the ductus arteriosus fails to properly close at or shortly after birth. This causes blood to circulate abnormally between two major arteries near the heart.

Heart Murmurs In Pediatric Patients: When Do You Refer


MICHAEL E. MCCONNELL, M.D., SAMUEL B. ADKINS III, M.D., and DAVID W. HANNON, M.D., East Carolina University School of Medicine, Greenville, North Carolina

Am Fam Physician. 1999 Aug 1 60:558-564.

See related patient information handout on heart murmurs in children, written by the authors of this article.

Many normal children have heart murmurs, but most children do not have heart disease. An appropriate history and a properly conducted physical examination can identify children at increased risk for significant heart disease. Pathologic causes of systolic murmurs include atrial and ventricular septal defects, pulmonary or aortic outflow tract abnormalities, and patent ductus arteriosus. An atrial septal defect is often confused with a functional murmur, but the conditions can usually be differentiated based on specific physical findings. Characteristics of pathologic murmurs include a sound level of grade 3 or louder, a diastolic murmur or an increase in intensity when the patient is standing. Most children with any of these findings should be referred to a pediatric cardiologist.

This article reviews the individual steps in the cardiac physical examination and the possible innocent or pathologic findings. The focus is on helping physicians become even more confident about their ability to diagnose innocent murmurs and to decide which patients might benefit from pediatric cardiology referral.

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Evaluation And Management Of Heart Murmurs In Children

JENNIFER E. FRANK, MD, and KATHRYN M. JACOBE, MD, University of Wisconsin Fox Valley Family Medicine Residency Program, Appleton, Wisconsin

Am Fam Physician. 2011 Oct 1 84:793-800.

Heart murmurs are common in asymptomatic, otherwise healthy children. These murmurs are often innocent and result from the normal patterns of blood flow through the heart and vessels.1 However, a heart murmur may be the sole finding in children with structural heart disease therefore, a thorough evaluation is necessary.


Structural heart disease is more likely when the murmur is holosystolic, diastolic, grade 3 or higher, or associated with a systolic click when it increases in intensity with standing or when it has a harsh quality.

Clinical recommendation Evidence rating References

Chest radiography and electrocardiography rarely assist in the diagnosis of heart murmurs in children.

Family physicians should order echocardiography or consider referral to a pediatric cardiologist for newborns with a heart murmur, even if the child is asymptomatic, because of the higher prevalence of structural heart lesions in this population.

A = consistent, good-quality patient-oriented evidence B = inconsistent or limited-quality patient-oriented evidence C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information about the SORT evidence rating system, go to .

What Happens In A Heart Murmur

Depending on a person’s age, the heart beats about 60 to 120 times every minute. Each heartbeat is really two separate sounds. The heart goes “lub” with the closing of the valves that control blood flow from the upper chambers to the lower chambers. Then, as the valves controlling blood going out of the heart close, the heart goes “dub.”

A heart murmur describes an extra sound heard in addition to the “lub-dub.” Sometimes these extra sounds are simply the sound of normal blood flow moving through a normal heart. Other times, a murmur may be a sign of a heart problem.

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Causes Of Child Heart Murmur

If an innocent murmur is ruled out, then the swishing sound can arise because of a defect in the heart. One in a hundred children with heart murmur has congenital defects arising in the valves or the major blood vessels. This inherent abnormality alters the pattern of blood flow, creating the characteristic murmur noise. Defects in the septum, separating the valves in the form of improper closure or a hole can cause a heart murmur. Transposed blood vessels also manifest as a heart murmur. Sometimes, these defects could also arise from endocarditis or rheumatic fever, and the doctor evaluates the child completely for the plausible reasons for murmur.

Premature children with heart murmur can have a condition called patent ductus arteriosus . This is a condition in which, the opening between two major blood vessels fail to develop in the foetal stage and is characterized by a heart murmur and poor weight gain. Sometimes, it is the only symptom that the child shows, making it a very critical diagnosis.

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