What Is a Heart Murmur? Causes, Tests, and What It Means

A heart murmur is an extra sound a doctor hears while listening to the heart. Many murmurs are harmless, but some can point to an underlying heart valve or structural problem that may need further evaluation.

Overview: What Is a Heart Murmur?

A heart murmur is an unusual sound heard between or during heartbeats when a doctor listens with a stethoscope. Instead of only the normal “lub-dub” sounds, there may be a soft whooshing or swishing noise caused by blood flow moving through the heart or its valves. A murmur itself is not a disease. It is a clinical sign that may be completely harmless or may suggest an underlying heart condition.

Heart murmurs are often described by when they occur in the heartbeat cycle, how loud they are, and where they are heard best on the chest. Some are discovered during a routine checkup in a person who feels completely well. Others are found when someone is being assessed for symptoms such as shortness of breath, tiredness, palpitations, or chest discomfort.

In many children, teens, and healthy adults, murmurs are “innocent” or “functional,” meaning the heart is normal and the sound comes from blood flowing briskly. In other cases, a murmur may be related to a heart valve that is narrowed or leaking, a structural change present from birth, or another medical condition affecting circulation. The main goal is to determine whether the murmur is benign or needs further investigation.

Symptoms and What a Murmur May Feel Like

A heart murmur usually does not cause a sensation by itself. Most people cannot feel or hear it. The symptoms, if present, come from the underlying cause rather than from the sound alone. That is why some people with a murmur have no symptoms at all, while others may develop signs of a heart or circulation problem.

Symptoms that can sometimes occur when a murmur is linked to a significant condition include breathlessness during activity or at rest, unusual tiredness, reduced exercise tolerance, chest discomfort, dizziness, fainting, palpitations, or swelling in the ankles and feet. In babies and young children, warning signs may include poor feeding, sweating during feeds, fast breathing, blue lips, or poor weight gain.

Doctors also look for clues on physical examination. They may notice changes in pulse, blood pressure, skin color, or signs of fluid retention. A murmur that appears together with symptoms does not always mean a serious condition, but it does make careful evaluation more important.

• Many harmless murmurs cause no symptoms at all.
• Symptoms suggest the heart may be working harder than usual.
• New or worsening symptoms should be discussed with a doctor.

Causes and Risk Factors

Heart murmurs are broadly divided into innocent murmurs and abnormal murmurs. Innocent murmurs happen when blood flows more quickly than usual through a normal heart. This can occur in children, during pregnancy, after exercise, or with conditions such as fever, anemia, or an overactive thyroid. These murmurs are common and often temporary.

Abnormal murmurs are more likely to be caused by a structural issue in the heart. A common cause is heart valve disease. A valve may become narrowed, called stenosis, or may not close properly, called regurgitation. These changes can affect the aortic, mitral, pulmonary, or tricuspid valves. Murmurs can also occur with congenital heart defects, such as a hole between heart chambers or changes in the outflow tracts.

Age can play a role. Older adults are more likely to develop valve calcification and wear-related valve changes. People with a history of rheumatic fever, heart infection, high blood pressure, prior heart disease, or certain inherited connective tissue conditions may also have a higher risk. In some people, a murmur may be related to heart valve disease or another structural heart problem that needs monitoring or treatment.

Risk factors do not confirm a serious diagnosis, but they help guide what tests may be appropriate. A doctor considers the person’s age, symptoms, medical history, family history, and examination findings when deciding whether a murmur is likely to be innocent or abnormal.

How Doctors Diagnose a Heart Murmur

Diagnosis begins with a medical history and physical examination. The doctor asks about symptoms, exercise tolerance, past heart conditions, infections, pregnancy, anemia, and family history of heart disease. During the exam, the murmur is assessed for timing, pitch, location, loudness, and whether it changes with breathing or body position. These details can offer useful clues about the cause.

The most important test for many people is an echocardiogram, an ultrasound scan of the heart. This test shows how the valves open and close, how blood moves through the heart, and whether there are structural abnormalities. It is painless and widely used to distinguish innocent murmurs from murmurs caused by valve or congenital heart conditions.

Other tests may also be recommended depending on the situation. An electrocardiogram can check the heart’s rhythm and look for signs of enlargement or strain. A chest X-ray may show the size of the heart or fluid in the lungs. Blood tests can help identify contributing conditions such as anemia, infection, or thyroid disorders. In selected cases, doctors may arrange exercise testing, Holter monitoring, or advanced imaging.

If the cause appears more complex, evaluation by a cardiologist may be advised. When needed, specialists may use echocardiography and other cardiac assessments to better define the murmur and decide whether observation, medication, or a procedure is appropriate.

Treatment Options and What Happens Next

Treatment depends entirely on what is causing the murmur. Innocent murmurs do not need medication, surgery, or activity restrictions in most cases. Reassurance and routine follow-up are usually enough. If the murmur is related to a temporary condition such as fever, anemia, or pregnancy, the sound may improve once that condition resolves or is managed.

When an abnormal murmur is caused by heart valve disease, treatment may include monitoring over time, medicines to support heart function or control symptoms, and management of associated conditions such as high blood pressure or irregular heartbeat. Not every valve problem requires immediate intervention. Some are mild and only need periodic echocardiograms and clinical review.

If a valve is severely narrowed or leaking, a procedure may be recommended. Depending on the valve involved and the person’s overall health, options may include repair or replacement. For some patients, evaluation for heart valve surgery becomes part of the care plan. In carefully selected cases, minimally invasive or catheter-based procedures may also be considered.

Children or adults with a congenital structural cause may need specialist follow-up and, in some situations, corrective treatment. The best approach is individualized. The aim is not to treat the murmur itself, but to treat the underlying problem and protect long-term heart function.

Prevention and Self-care

Not all heart murmurs can be prevented, especially those present from birth or related to age-related valve changes. However, good cardiovascular care can lower the risk of some underlying problems and support overall heart health. This includes regular blood pressure checks, managing cholesterol and diabetes, not smoking, staying physically active, and following a balanced diet.

It is also important to manage medical conditions that can contribute to murmurs or make heart disease harder on the body. Treating anemia, controlling thyroid disease, and seeking care for infections are examples. People who already know they have a valve condition should attend follow-up appointments and ask their doctor which symptoms to watch for.

Self-care also means avoiding assumptions. A newly discovered murmur should not be ignored, but it should not automatically cause fear either. Many murmurs are harmless. The safest step is a proper assessment so that reassurance or treatment is based on clear findings rather than guesswork.

For people who have an established heart condition, a personalized plan may include activity guidance, medications, and periodic testing. Some may also need ongoing review for related cardiovascular concerns such as arrhythmia if palpitations or rhythm changes are present.

When to See a Doctor

A person should see a doctor if a heart murmur is newly detected or if symptoms suggest the heart may not be working efficiently. Important symptoms include shortness of breath, chest pain, fainting, unexplained fatigue, palpitations, swelling in the legs, or reduced ability to exercise. In infants and children, rapid breathing, poor feeding, blue discoloration, or poor growth should be assessed without delay.

People who already know they have a murmur should seek review if symptoms change or worsen. Follow-up is especially important for anyone who has been told they have a valve problem, a congenital heart defect, or previous heart infection. Prompt reassessment can help detect progression early and guide the next steps in care.

Although many murmurs are benign, only an examination and, when needed, imaging can confirm that. At the end of the diagnostic pathway, some patients may need specialist heart care. Acibadem International’s multidisciplinary specialists in JCI-accredited hospitals evaluate and treat heart murmurs and related structural or valve conditions for international patients, including advanced testing and referral for cardiology care when appropriate.

Frequently asked questions

Is a heart murmur always serious?

No. Many heart murmurs are innocent, especially in children, young adults, and during pregnancy. A murmur becomes important when it is linked to symptoms or an underlying heart problem, which is why medical assessment is useful.

Can adults develop a heart murmur later in life?

Yes. Adults can develop a heart murmur due to valve changes, anemia, fever, thyroid disease, pregnancy, or other conditions that affect blood flow. In older adults, age-related valve narrowing or leakage is a common reason.

What test is usually used to check a heart murmur?

An echocardiogram is often the main test used to evaluate a heart murmur. It uses ultrasound to show the heart’s structure, valve movement, and blood flow, helping doctors identify whether the murmur is harmless or related to a heart condition.

Can a heart murmur go away on its own?

Some can. Innocent murmurs may change over time or disappear, and murmurs caused by temporary conditions such as fever or anemia may improve when that problem is treated. Murmurs due to valve disease usually do not go away without addressing the underlying cause.

Can someone exercise with a heart murmur?

Often yes, especially if the murmur is innocent and there are no symptoms. If a structural heart problem is suspected or confirmed, a doctor may give personalized advice about the type and intensity of exercise that is safest.

What is the difference between a heart murmur and a valve problem?

A heart murmur is the sound a doctor hears, while a valve problem is one possible cause of that sound. In other words, a murmur is a finding on examination, not the diagnosis itself.

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.