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Heart Murmurs: Harmless or Dangerous?

May 13, 2024

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When your doctor listens to your heart with a stethoscope and hears a consistent ‘lub-dub’ rhythm, there’s usually no cause for concern. But if they hear a whooshing or swishing sound between lubs and dubs, it may be a sign of a heart murmur.

“When people hear the words heart murmur, it immediately causes distress,” says Amar Shere, MD, a cardiologist at Atlantic Health System. “I reassure patients that most heart murmurs are innocent and quite common, especially in young people. The vast majority do not require treatment, rarely escalate into a significant health issue, and often disappear in time.”

What Is a Heart Murmur?

A heart murmur is an abnormal sound heard during a heartbeat cycle, typically caused by turbulent blood flow within the heart or in nearby blood vessels. Although most heart murmurs are innocent and do not pose a significant health risk, an abnormal murmur requires medication, lifestyle changes and, in some cases, surgical intervention.

“Innocent heart murmurs are benign and harmless,” says Dr. Shere. “A murmur is only concerning if it is associated with other symptoms such as chest pain, fatigue, fainting or shortness of breath.”

When Is a Heart Murmur Cause for Concern?

To determine the cause and severity of the murmur, your cardiologist will perform transthoracic echocardiogram (TTE) and electrocardiogram (ECG) testing to evaluate the intensity, duration and pitch of the murmur. An abnormal or pathological murmur can indicate a heart valve disorder, congenital heart defect, or cardiovascular conditions such as aortic stenosis or mitral regurgitation.

It also requires intervention, which typically start with conservative measures to manage a patient’s symptoms using medications and lifestyle changes. When left unmonitored or untreated, a pathological heart murmur can trigger heart failure, stroke or sudden cardiac death.

“When a heart murmur is associated with symptoms related to an underlying severe valve disease, it’s time to escalate management,” says Dr. Shere. “There are many interventions we can consider before a patient would need surgery.”

How Is a Pathological Heart Murmur Treated?

Pathological heart murmurs related to severe valvular disease are typically managed by replacing or repairing the valve. In the rare case that surgery is needed, Dr. Shere explains that a cardiothoracic surgeon would perform a valve replacement procedure through open heart surgery. There are also less invasive options that an interventional cardiologist can perform by inserting a catheter into the femoral artery of the groin to access the diseased valve.

“As a cardiologist, patients are often referred to me by their primary care doctor for further testing,” says Dr. Shere. “I evaluate the heart’s structure, function and severity of the murmur, and recommend a treatment plan. In many cases, regular monitoring can be enough to keep symptoms at bay, prevent complications and keep the murmur from progressing into a more serious issue.”

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  • Heart Health