Parents have been sounding off to me with lots of questions about heart murmurs in their children. Let me get to the heart of the matter to provide some information on this topic.

What is a heart murmur, exactly?

A heart murmur is simply a noise heard between the beats of the heart due to the flow of blood through the heart. In fact, it sounds like water flowing through a hose.  While the term heart murmur may sound scary, for most children it’s extremely common and doesn’t mean anything is wrong. Usually, it means that blood is whooshing through the pipes and sounds louder.

Should I worry about the murmur?

We worry most about infants at birth and in the first few months of life. This is because the murmur might be a signal that there is a congenital abnormality involving the heart. There may be an abnormal connection between chambers, problems with valves controlling blood flow in the heart, or the major blood vessels coming from the heart.

If a baby appears blue in the face and has a murmur, which occurs rarely, your doctor will do other tests such as a chest x-ray and an electrocardiogram. These are used to diagnose whether or not a heart problem exists. If the murmur does exists, you doctor will refer your child to a pediatric heart specialist. That specialist will do an echocardiogram or ultrasound of the heart to determine the diagnosis and further treatment.

When a child reaches preschool age and is noted to have a murmur, this is usually less cause for concern.  By examining your child and listening to the sound, your child’s health care professional should be able to determine if further testing is needed, but most of the time it is not.

Is treatment necessary?

If the murmur is just due to blood flowing noisily through the heart, treatment is not needed. We call this an “innocent murmur” due to noisy blood flow.

However, a follow-up visit or two may be requested to make sure the sound is not changing or has gone away. If the flow is stronger because your child is anemic and needs to make more red blood cells, iron therapy might be required. If no therapy is indicated, restricting your child from sports or other physical activities is not necessary.

When do we otherwise worry about a murmur in an older child? We do this only if it is accompanied by rapid breathing, chest pain, or an older child being very tired or passing out. These are very rare occurrences.

Hopefully tips like these will mean you won’t miss a beat when it comes to knowing more about heart murmurs.

Lewis First, MD, is chief of Pediatrics at The University of Vermont Children’s Hospital and chair of the Department of Pediatrics at the University of Vermont College of Medicine. 

Lewis First, MD, is chief of Pediatrics at The University of Vermont Children’s Hospital and chair of the Department of Pediatrics at the Robert Larner, M.D. College of Medicine at the University of Vermont.

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