Heart Murmurs in Children


Nita Doshi, M.D., pediatric cardiologist at CHOC Children’s

As Heart Month comes to a close, check out these helpful facts about heart murmurs in children from Dr. Nita Doshi, pediatric cardiologist at CHOC Children’s.

My pediatrician heard a “heart murmur” in my child.  What is a heart murmur?

A “heart murmur” is an extra noise or sound which can be heard when listening to the heart with a stethoscope.  When blood travels through the veins, arteries, and valves of the heart, the flow of blood can create a sound.  This sound has often been described as having a “swishing” or “whooshing” quality. This sound is frequently referred to as a “heart murmur.”

Does the finding of a heart murmur mean that something is wrong with my child’s heart?

It is very important to remember that a “heart murmur” is simply a noise or a sound.  It is a finding detected by listening through a stethoscope during an examination.  Most of the time, heart murmurs are normal and do not indicate anything is wrong with the heart.

How commonly are heart murmurs diagnosed in children?

Studies have estimated that up to 90% of infants and children will have a heart murmur at some point during infancy or childhood.  But of all heart murmurs, only about 1-3% of children will be found to have a congenital heart problem.

What is an “innocent” murmur?

Innocent heart murmurs have also been called:  “benign,” “physiologic,” “functional,” or “flow-related,” meaning that normal blood flow creates a sound which can be heard during examination.  In younger children, it is often easier to hear a murmur because the distance between the heart and the chest wall is typically closer.  Because innocent heart murmurs are related to blood flow as well as changing chest configuration and heart rate, heart murmurs may disappear and reappear at various times.  As an example, periods of increased activity and fever are common times when a heart murmur may be heard.

What is a “non-innocent” murmur?

Heart murmurs can be termed “non-innocent” or “pathologic,” meaning that the sound may represent an abnormality of the heart muscle, walls, valves, or arteries.  For instance, a pathologic murmur can represent the sound of blockage of outflow from the pumping chambers, which dispenses blood to the lungs and the body.  It may also signify a hole within the wall inside the heart, narrowing or malformation of one of the heart valves, leakage of one of the heart valves, or narrowing of one of the arteries supplying blood to the lungs or body.

What may further evaluation of a heart murmur involve?

Your pediatrician may choose to refer your child with a heart murmur to a pediatric cardiologist.  A pediatric cardiologist is a specialist of heart disease in fetuses, infants, children, and young adults.  Your pediatrician or pediatric cardiologist may decide to order an “electrocardiogram,” which is a non-invasive test that measures the electrical activity or rhythm of the heart.  Your pediatrician or pediatric cardiologist may decide to order an “echocardiogram” otherwise known as an ultrasound of the heart, which is another type of non-invasive test that can further evaluate the structure and function of the components of the heart.

Find more information about programs and services at the CHOC Children’s Heart Institute.

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