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understanding heart murmurs

Understanding Heart Murmurs

“Your baby has a heart murmur” is not a statement any parent wants to hear when they visit the doctor for a checkup. In fact, you will most probably feel ill to your stomach at the mention of a heart murmur. Knowing that “some heart murmurs are completely harmless” and that as many as half of all children have heart murmurs in the first 18 years of life, may just help when receiving this news.

Every time a heart beats, two sounds are created. Think back to the very exciting time when you had the first scan. Hearing the whooshing sound of that little heartbeat is such a miracle. It is usually described as “lubb-dupp”, and is created when the heart valves open and close. When there is an extra sound, over and above the expected “lubb-dupp”, then this is known as a murmur.

Is a heart murmur dangerous?

  • Innocent murmurs

    Just as its name suggests, an innocent heart murmur doesn’t cause harm. In such cases, there is no issue with the structure of the heart. The extra sound originates from the flow pattern of the blood through the heart. It can be heard at any time during a child’s early years and often into adolescence. This kind of heart murmur won’t usually be associated with any signs or symptoms but may appear for the first time after an illness, especially if the child has had a high fever.

  • Pathogenic murmurs 

    These murmurs arise as a result of a structural abnormality of the heart or heart vessels. Children are born with these abnormalities and are often referred to as congenital abnormalities. These abnormalities may be things like a hole in the heart, a cardiac shunt (where there is abnormal blood flow between the chambers or vessels) or a problem with the heart valves. Children with abnormalities in the structure of the heart will usually display signs and symptoms and these may include:

    1. Poor feeding which results in insufficient weight gain
    2. Bluish skin which is particularly noticeable on the lips and fingertips
    3. Excessive sweating
    4. Coughing without an apparent cold
    5. Swelling of the lower legs, feet or abdomen
    6. Swelling of the liver or neck veins
    7. Dizziness or fainting
    8. Chest pain

Are there other causes of heart murmurs?

  • Rheumatic fever

    This is usually a secondary illness following a throat infection, specifically caused by a bacteria known as Streptococcus. This bacteria can affect the heart valves if it is not treated with antibiotics.

  • Anaemia

    A child with a persistent, low red cell count is at risk of developing a murmur.

  • Hyperthyroidism

    A child with an overactive thyroid gland may also develop a murmur.

  • Endocarditis

    A child with a serious infection may be at risk of developing this condition. The infection found elsewhere in the body may travel through the bloodstream and attack the heart valves or lining.


How is a heart murmur diagnosed?

When your baby is examined, the healthcare provider will use a stethoscope to listen to the heart. What they will be listening for is the normal two beats described in the introduction. If the healthcare provider hears an abnormal sound he or she may recommend that your baby see a paediatric cardiologist. Tests may be performed to look at the structure of the heart as well as to measure the electrical activity of the heart. Such tests may include an x-ray, ECG or echo of the heart.


What treatment will my baby receive if he or she has a heart murmur?

The treatment for a heart murmur will depend on the symptoms, age of your baby and what your baby’s general health is like.

The innocent heart murmurs don’t need any treatment and usually go away on their own. Remember these are the most common type of murmurs in children.

Congenital heart problems may require surgery or to be treated with medication.


Is there anything I can do to prevent my baby from having a heart murmur?

  • During pregnancy

There are certain illnesses like uncontrolled diabetes or rubella which, during pregnancy, may affect how your baby’s heart develops. Mothers with diabetes must ensure that their own health is well managed during this sensitive time. Ensuring that you are vaccinated against Rubella before you fall pregnant is also advisable.

Alcohol and drugs definitely affect the developing heart of a foetus and should be avoided at all costs. Certain medications may also increase the risk of your baby developing heart problems. For this reason, a woman should always consult her healthcare provider before taking medication during pregnancy.

  • Childhood

Certain illnesses, like throat infections, may lead to heart problems. For this reason, it is always advisable to get medical help if your child is ill. Children with anaemia should be treated with an iron supplement and followed up regularly.



Hearing that your baby has a heart murmur can be very distressing and rightly so. What is important is that you reassure yourself with the knowledge that most murmurs are innocent. Modern medicine is able to provide incredible solutions for children with congenital heart problems, although the road may seem long. Do your best to take care of yourself while you are pregnant. Your developing baby will benefit so much from this. If your child is ill follow your gut. An illness like tonsillitis may seem like a common childhood sickness but left untreated can lead to heart problems. There is a saying “the best gifts come from the heart and not from the store”. In the case of your child health, nothing could be truer than this.



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