What Does It Mean If You Have a Heart Murmur as an Adult?
Key takeaways:
A heart murmur is the sound of blood moving through the heart that differs from a regular heartbeat.
Not all heart murmurs are dangerous or a sign of a heart problem.
Some heart murmurs may be a sign of underlying heart disease. Your provider can identify these distinct sounds and guide you through further testing to look for a cause.
Table of contents
A murmur is an extra sound the heart makes as it pumps blood. But a heart murmur isn’t always a cause for concern. And it doesn’t mean there is something wrong with your heart. Many times, it means your provider will watch it by listening to your heart at every visit. Other times, they will order more tests or have you see a heart doctor to check it out. So here’s what to know if you’ve recently learned that you have a heart murmur.
What is a heart murmur?
Murmurs are caused by turbulent or choppy blood flow moving through the heart. Murmurs can sound like a loud whooshing, rumbling, blowing, or clicking sound. But a heart murmur is not a medical problem or a diagnosis in itself. It’s the name for a sound that providers might hear when listening to your heart. Learn about the different types of murmurs and when you should get evaluated.
What causes a heart murmur?
There are two main groups of murmurs based on their causes:
1. Innocent heart murmurs, which usually occur with changes in the body.
2. Abnormal heart murmurs, which are a sign of a heart condition.
Innocent heart murmurs
Innocent murmurs sound like a “whooshing” or “swishing.” These sounds are from blood moving through the heart between heartbeats. These types of murmurs don’t cause symptoms and don’t need treatment. Providers can listen to identify them. And they have different characteristics than abnormal murmurs. Innocent murmurs can come and go. This means that they’re easier to hear when extra blood flows through your heart or your heart rate is fast.
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Some of the things that can cause an innocent murmur are:
Pregnancy: This is because of many changes in the body during pregnancy. For example, the amount of blood moving through the body increases.
Anemia: This occurs when there aren't enough red blood cells to carry oxygen throughout the body. The blood must then move faster, so the heart will also beat faster. Your provider might hear this as extra sounds as blood moves through the heart.
High heart rate: Anything that increases someone’s heart rate can lead to a murmur. Common examples include fever or high thyroid levels.
Young age: It’s very common for children to have an innocent heart murmur. This is because of how the heart sits in the chest as they grow. These murmurs often disappear as they age but may continue into adulthood.
Older age: Heart arteries and valves become stiffer with age. When the heart squeezes blood out to the body, your provider might hear this as a soft murmur.
Abnormal heart murmurs
Some heart murmurs may show a problem with the heart. Abnormal heart murmurs sound different from innocent heart murmurs. Your provider can listen to tell the difference between the two.
Some of the most common causes of abnormal heart murmurs in adults are:
Heart valve conditions: Heart valves help move blood forward through the different heart chambers. Murmurs can happen when valves become stiff or tight — like with aortic stenosis. Or they can become leaky and allow blood to move backward — like with mitral regurgitation.
Heart failure: Sometimes, the heart doesn’t squeeze well, or the heart muscle is stiff. This can cause extra sounds when the blood hits against the heart wall as it fills.
Infections of the heart valves: Bacteria that enter the bloodstream can stick to the heart valves (endocarditis). This can damage the heart valves and lead to a murmur.
Congenital heart defects: These are problems with the heart structure that you’re born with. While usually diagnosed in childhood, some defects might not show up until adulthood.
What are symptoms of a heart murmur?
Not all heart murmurs cause symptoms — especially innocent murmurs. If new symptoms appear, work with your provider to figure out next steps for treatment. This can be a sign that the heart murmur is due to underlying heart disease. Some symptoms include:
Chest pain
Trouble breathing
Shortness of breath when lying flat
New cough
Bulging neck veins
Fast or unexplained weight gain
Racing heartbeat
Fever or night sweats
Unusual sweating
Excessive fatigue
How is a heart murmur treated?
Treatment for a heart murmur depends on the cause and presence of symptoms. For many innocent murmurs, you don’t need any treatment. And you can keep your regular follow-up schedule.
But an innocent murmur can occur because of low blood count or thyroid problems. In this case, you may need treatment for the underlying cause. Usually, treating the underlying problem will make the murmur go away.
If you see new symptoms — or your murmur sounds more like an abnormal heart murmur — you may need more testing. You and your provider can work together to find a cardiologist, a provider with special training in the heart.
Tests that can determine the cause of a heart murmur include:
Echocardiogram (echo) to provide images of the heart
Chest X-ray to look at the heart size and the lungs
Electrocardiogram (ECG) to check the heart rhythm
Remember that the treatment that follows depends on the cause. Minor valve problems that don’t cause symptoms can usually be watched. If the heart valve problem affects your heart pump function or causes symptoms, surgery can fix or replace the valve. Sometimes, a new heart valve can even be placed with a cardiac catheterization. This allows for a solution without the need for surgery.
Heart murmur myths
It can be scary to get any new diagnosis — especially when associated with the heart. But misconceptions about heart murmurs cause unnecessary worry.
Here are a few things to remember:
Not all heart murmurs are the same. Many things can cause a heart murmur, and many of them are not medical problems that need treatment.
If you had a heart murmur as a kid, you will not necessarily have one as an adult. Most people grow out of heart murmurs that they had as a child.
Heart murmurs are not preventable. It’s always a good idea to do things that take care of your heart health, but there’s no specific way to prevent a heart murmur.
You don’t always need medication for a heart murmur. There is no medication needed to treat a heart murmur itself. If you have a heart murmur related to abnormal heart function or valve function, medications might help your symptoms.
If you have a heart murmur, you don’t necessarily need to see a cardiologist. Quiet murmurs usually don’t need any workup and can be followed by your healthcare provider.
Heart murmurs can come and go. Different conditions can change how fast blood moves through the heart.
Not all murmurs need treatment. Louder murmurs can show a problem with the heart that might need treatment. But you don’t need treatment if you have a murmur without a heart problem.
The bottom line
A heart murmur is an extra sound heard when listening to your heart. Not all murmurs are a cause for concern or mean that you have a heart problem. Your healthcare provider can usually watch over innocent murmurs. Extra tests can help figure out the cause of a heart murmur and ensure it’s not a sign of a bigger problem. Talk with your provider if you have a heart murmur. Remember to ask about the type of murmur and how you should track it.
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References
American Heart Association. (2020). Heart valves and infective endocarditis.
Chietlan, M. D. et al. (1997). ACC/AHA guidelines for the clinical application of echocardiography. Circulation.
Fang, J. C., et al. (2021). History and physical examination: An evidence-based approach. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine.
Fink, J. C., et al. (1994). A decision aid for referring patients with systolic murmurs for echocardiography. Journal of General Internal Medicine.
Otto, C. H., et al. (2020). 2020 ACC/AHA guidelines for the management of patients with valvular heart disease: Executive summary: A report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation.
Porter, W. B. (1953). The heart in anemia. Circulation.
Sanghavi, M., et al. (2014). Cardiovascular physiology of pregnancy. Circulation.
Shub, C. (2003). Echocardiography or auscultation: How to evaluate systolic murmurs? Canadian Family Physician.
