Thu, October 6, 2011

Heart Murmurs in Children

Heart murmurs in children are very common. Fortunately most heart murmurs in children are innocent.

A heart murmur simply means a noise or sound that is heard in the heart. Heart murmurs in children are very common. Fortunately, most heart murmurs in children are innocent or functional.

What causes heart murmurs in children?

There are many different types of heart murmurs.  Some murmurs are sounds which are produced by defects or abnormalities with the heart, for example congenital heart defects.  Examples of common forms of congenital heart defects include an atrial septal defect, ventricular septal defect, patent ductus arteriosus, pulmonary valve stenosis, and bicuspid aortic valve. With these heart defects, a murmur is produced as the blood flows turbulently through either a hole or past an abnormal valve.

On the other hand, many heart murmurs in children are termed innocent or functional murmurs.  This implies that there is no problem whatsoever with the heart, and that the murmur or sound is simply being produced by the normal flow of blood through the heart.  Fortunately, the majority of heart murmurs in children are innocent murmurs!

An easy way to think about an innocent murmur is to compare it to water that flows out of a faucet.  Almost any faucet will make some noise as water flows from it. Some faucets make louder noises than others.  However, just because one faucet is louder than another, this doesn't mean that there is a problem with that faucet!  Likewise, when blood (a liquid) flows through the heart, in some children it may make a louder noise than in other children, despite the fact that the heart is perfectly normal.

What symptoms do heart murmurs in children cause?

Symptoms associated with a heart murmur depend entirely on what is causing the murmur. Since an innocent heart murmur is a normal finding, no symptoms whatsoever would be expected. Symptoms from a heart murmur caused by a specific defect will vary depending on the type of defect. 

How are heart murmurs in children diagnosed?

Often times an innocent murmur can be identified simply by listening.  Many innocent murmurs have very typical sounds which can easily be identified by a doctor with an experienced ear.  Occasionally further testing might be necessary.  This might include an echocardiogram to evaluate the structure of the heart and look closely at the valves and walls of the heart. 

Do heart murmurs in children require treatment?

Treatment for a heart murmur depends entirely on what is causing it. Treatment for heart murmurs caused by specific heart defects will vary depending on the type of defect. On the other hand, innocent heart murmurs require no treatment whatsoever.

Once a heart murmur is determined to be innocent, then one can rest assured that the heart is completely normal.  Since the heart is normal, no special restrictions or precautions are needed.  Often times there are questions as to whether antibiotics are needed before dental work (SBE prophylaxis).  This precaution is only reserved for those people who have heart murmurs due to actual heart defects.  Likewise, since the heart is normal, with an innocent murmur there is no need for any restrictions with sports or athletics.  A child with an innocent heart murmur is not at any increased risk for heart related problems in the future. 

Just as an innocent murmur may appear at any age out of the blue, often it will disappear with time.  However, it is also possible for an individual to have the same innocent heart murmur for a lifetime.  In the end, whether or not the murmur disappears is not important.  The important thing to remember with heart murmurs that are innocent is that the heart is completely normal!

In summary, heart murmurs in children are very often innocent and require no treatment whatsoever.