What Does a Heart Murmur Mean?

A heart murmur is an extra sound heard during a heartbeat. It can be completely harmless, but in some people it points to a heart valve problem or another underlying condition that needs medical attention.

Overview: what a heart murmur means

A heart murmur is an unusual sound heard between the normal “lub-dub” sounds of the heartbeat. A doctor usually hears it through a stethoscope during a routine examination. The sound is caused by blood flowing through the heart or nearby blood vessels in a way that creates turbulence.

Importantly, a heart murmur is not a disease on its own. It is a clinical finding that can be either harmless or related to an underlying problem. Many people, including children and healthy adults, have what is called an innocent or functional murmur. This type does not damage the heart and often needs only observation.

In other cases, a murmur can be linked to a structural heart issue, especially a problem with one or more heart valves. It may also appear when blood flow changes because of fever, anemia, overactive thyroid function, or pregnancy. The meaning of a heart murmur depends on the person’s age, symptoms, medical history, and the characteristics of the sound.

Symptoms: when a murmur may be harmless or significant

Most innocent heart murmurs do not cause symptoms. People often learn they have one during a check-up, sports physical, pregnancy visit, or examination for an unrelated illness. In these cases, the person generally feels well and has no signs of heart disease.

When a murmur is related to an underlying heart problem, other symptoms may be present. These can develop gradually or appear more clearly with physical activity. Symptoms that deserve medical attention include:

• Shortness of breath, especially with exertion or when lying flat
• Chest discomfort or pressure
• Fatigue or reduced exercise tolerance
• Palpitations or awareness of a rapid, fluttering heartbeat
• Dizziness, fainting, or near-fainting
• Swelling in the ankles, legs, or abdomen
• Bluish lips or fingertips, especially in infants or children

In babies and children, poor feeding, slow growth, sweating with feeding, or unusual tiredness can suggest that a murmur needs further evaluation. In adults, new symptoms together with a newly detected murmur may point to heart valve disease or another cardiovascular condition.

Causes and risk factors

Heart murmurs are broadly divided into innocent murmurs and abnormal murmurs. Innocent murmurs happen when blood flows a little faster than usual through a normal heart. They are common in childhood and can also occur in adults during pregnancy, exercise, fever, or anemia. These murmurs are usually soft, brief, and not associated with symptoms.

Abnormal murmurs are often related to a structural issue in the heart. A frequent cause is a valve that is narrowed or does not close properly. For example, a tight valve opening can reduce forward blood flow, while a leaking valve allows blood to move backward. These changes can create a murmur and may eventually strain the heart.

Other causes include congenital heart defects present from birth, infection of the heart valves, age-related valve calcification, high blood pressure affecting the heart, and enlarged heart chambers. Conditions such as rheumatic heart disease are less common in some regions but remain an important cause globally. Some murmurs are associated with congenital heart disease identified in infancy, childhood, or even adulthood.

Risk factors for an abnormal murmur include older age, a family history of heart defects, prior rheumatic fever, uncontrolled high blood pressure, previous heart infection, and chronic illnesses that affect the heart. Even so, hearing a murmur does not automatically mean a person has serious heart disease; the next step is careful assessment.

How doctors diagnose a heart murmur

Diagnosis begins with a medical history and physical examination. The doctor listens closely to the murmur’s timing, loudness, location, and quality. Certain patterns make an innocent murmur more likely, while others suggest a valve or structural problem. The doctor also asks about shortness of breath, chest pain, fainting, fever, prior heart conditions, and family history.

If the murmur appears likely to be innocent and the person has no symptoms, no further testing may be needed right away. If there are concerning features, an echocardiogram is usually the most important next test. This ultrasound scan shows the heart’s chambers, valves, and blood flow in real time, helping doctors identify narrowing, leakage, or congenital abnormalities.

Additional tests may include an electrocardiogram to assess heart rhythm, a chest X-ray to look at heart size and lung congestion, and blood tests for conditions such as anemia or infection. In some cases, doctors may recommend exercise testing, cardiac MRI, or specialist follow-up with a cardiologist. Accurate diagnosis is important because treatment is based on the cause, not the murmur alone.

Treatment options

Treatment depends entirely on what is causing the heart murmur. Innocent murmurs do not need medicines or procedures. Reassurance and routine follow-up are usually enough, especially when the person has no symptoms and the heart is structurally normal on examination or imaging.

If the murmur is caused by another medical issue, treatment focuses on that condition. For example, correcting anemia, treating fever or infection, or managing thyroid disease may reduce or resolve the murmur. When high blood pressure or heart failure contributes to abnormal heart sounds, medication and lifestyle changes can help support heart function.

When a heart valve is significantly narrowed or leaking, treatment may include monitoring, medicines to control symptoms, or a procedure to repair or replace the valve. Depending on the problem, doctors may consider heart valve repair or replacement or a less invasive option such as TAVI for selected patients with severe aortic valve disease. Some people also benefit from treatment for related rhythm or blood flow problems through specialist cardiology care.

People with congenital structural causes may need long-term follow-up, and some may require intervention at different stages of life. Near the end of the care pathway, a multidisciplinary center can be helpful; Acibadem International’s specialists in JCI-accredited hospitals evaluate and treat heart murmurs and their underlying causes for international patients.

Prevention and self-care

Not all heart murmurs can be prevented, especially innocent murmurs and congenital causes. However, general heart-healthy habits can reduce the risk of conditions that lead to abnormal murmurs. These include staying physically active, eating a balanced diet, maintaining a healthy weight, not smoking, and managing blood pressure, cholesterol, and diabetes.

Regular medical care is also important. Prompt treatment of infections, follow-up for known heart conditions, and discussion of new symptoms with a doctor can help prevent complications. People with known valve disease should attend scheduled check-ups so changes can be detected early.

Self-care also means understanding the difference between monitoring and ignoring symptoms. A person who has been told they have an innocent murmur should still seek medical advice if they later develop breathlessness, chest discomfort, fainting, or reduced exercise tolerance. These symptoms may reflect a separate heart problem even if the original murmur was harmless.

When to see a doctor

A newly discovered heart murmur should be assessed by a qualified doctor, especially if it occurs together with symptoms or if the person has a history of heart disease. In many cases, the evaluation is straightforward and reassuring. Seeing a doctor helps determine whether the murmur is innocent or whether further testing is needed.

Medical review is especially important for shortness of breath, chest pain, fainting, swelling in the legs, fever with a known heart condition, or blue discoloration of the lips or fingers. Babies and children should be checked promptly if they have poor feeding, poor growth, sweating with feeds, or unusual tiredness.

Urgent care is needed if symptoms are severe, sudden, or rapidly worsening. Timely assessment can identify treatable problems such as significant valve disease, infection, or heart failure. With the right diagnosis and follow-up, many people with a heart murmur do very well.

Frequently asked questions

Is a heart murmur always serious?

No. Many heart murmurs are innocent, meaning they occur in a normal heart and do not cause harm. A doctor may still recommend evaluation to confirm whether the murmur is harmless or related to another condition.

Can adults develop a heart murmur later in life?

Yes. Adults can develop a murmur because of heart valve changes, high blood flow states such as anemia or pregnancy, or other heart conditions. A new murmur in adulthood should be assessed, especially if symptoms are present.

How is a heart murmur checked?

A doctor first listens to the heart with a stethoscope and reviews symptoms and medical history. If more information is needed, an echocardiogram is commonly used to look at the heart valves, chambers, and blood flow.

Can a heart murmur go away on its own?

Some can. Innocent murmurs may become less noticeable over time, especially in children, or may disappear when a temporary cause such as fever resolves. Murmurs caused by structural heart problems usually do not go away unless the underlying issue is treated.

What is the difference between an innocent and an abnormal murmur?

An innocent murmur happens in a structurally normal heart and usually causes no symptoms or complications. An abnormal murmur is linked to a condition such as a valve problem or congenital heart defect and may require monitoring or treatment.

Can someone exercise with a heart murmur?

Often yes, especially if the murmur is innocent and there are no symptoms. However, exercise advice should be individualized, and people with an abnormal murmur or symptoms should ask their doctor what level of activity is safe.

References

• American Heart Association
• National Heart, Lung, and Blood Institute
• European Society of Cardiology
• Mayo Clinic
• National Health Service

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.