Are you hearing a strange sound in your heart? Is it a Heart Murmur''? Let's talk about this!

If a doctor were to put a stethoscope to your heart and say, 'I can hear a little sound in your heart, it's a murmur,' wouldn't you be a little scared? Or if you were to show your little child to the doctor and they said something like that? What exactly is this heart murmur, or ``Heart Murmur''? Let's talk about this simply.

What does a "murmur" in the heart mean?

When our heart beats, that is, when it pumps blood, the valves in the heart open and close. Like doors. When these valves close, you hear two sounds called 'lub-dub' . Have you ever seen a doctor put a stethoscope on your chest and listen? That's what you hear. But, sometimes, in addition to this 'lub-dub' sound, you hear a sound like 'whoosh' or 'swish' as ​​if it is filling with air. That's what we call a `(Heart Murmur)`, in Sinhala, a murmur of the heart. This means that there is some small abnormality in the way blood flows through the valves of your heart.

Is this ``Heart Murmur'' something that happens to many people?

Yes, this is actually very common. You might not even think about it, most of us have had a 'harmless' `(Heart Murmur)` at some point in our childhood, meaning a murmur that occurs without any underlying disease. So there's no need to panic when you hear this name.

Are there types of `(Heart Murmur)`?

There are. These are classified according to when in the heart's beating cycle this sound is heard.

Simply put:

• Systolic murmur: This is heard when your heart muscle contracts, meaning it pushes blood out.
• ``Diastolic`` murmur: This is heard when the heart muscle relaxes, that is, when it is filling with blood again.
• ``Continuous`` Murmur: This is heard when the heart contracts and relaxes, meaning it is heard throughout the cycle.

Generally, ``Diastolic`` and ``Continuous`` murmurs are more likely to be associated with heart disease. However, it is very important to have any ``Heart Murmur`` checked by a doctor.

How loud is a ``Heart Murmur''?

We don't hear this with our ears. It's only when a doctor listens with a stethoscope that we can clearly identify this sound. Because the stethoscope magnifies this sound.

Doctors classify the intensity of this murmur, that is, how loud the sound is. There is a scale for that, from 1 to 6.

• Grade 1: Barely audible even with a stethoscope.
• Grade 6: The stethoscope is loud enough to be clearly heard even if it is not pressed against the skin.

What are the causes of this `(Heart Murmur)`?

As I mentioned before, a murmur is caused by turbulent flow or abnormal blood flow through the heart valves.

How do innocent, that is, healthy ``Innocent Heart Murmurs'' occur?

Sometimes, when blood is flowing faster than normal, an ``innocent'' heart murmur can occur. This is also called a ``normal'' or ``physiologic'' murmur. These are not caused by any disease. They are common in cases like these:

• As a child: This is very common for young children.
• When exercising: When we run and jump, our heart beats faster, that's when.
• During periods when children grow rapidly (growth spurts).
• During pregnancy: This can also happen when you are a mother-to-be.
• In the first few days after a baby is born.

These innocent murmurs can sometimes come and go, then come back. They can also get louder when your heart is beating faster. Most of the time, they go away on their own over time. But for some people, they can last a lifetime. The important thing is that these innocent murmurs don't mean there's anything wrong with your heart.

Heart Murmurs, which may be caused by heart disease or another condition

Some ``Heart Murmurs'' can be caused by a heart condition or other health problem. Let's take a look at what they are:

• Anemia: This means a decrease in the number of red blood cells in the blood. This affects the viscosity of the blood, which can lead to a heart murmur. Symptoms include feeling weak and tired. Imagine, Nimali is always tired and can't do anything. She only finds out that she has low blood pressure when she goes to the doctor. She also had a heart murmur.

• Carcinoid syndrome or carcinoid heart disease: This is a slow-growing cancer. It is caused by excess hormones, which can also affect the heart. You may also see weight loss, stomach pain, diarrhea, and low blood pressure.

• Congenital heart defect: A problem with the structure of your heart, or the way it is formed, that you are born with. For example, a hole in the heart (a `septal defect`) or conditions like `Tetralogy of Fallot`.

• Endocarditis: This is an infection of the heart. Bacteria or other germs can enter the bloodstream and attack the heart valves. This can cause additional symptoms such as fever, chills, skin rashes, and a sore throat.

• Heart valve disease: This is when one or more of the heart's valves do not work properly. This prevents blood from flowing properly. For example, a valve may become stiff (valve stenosis). Or it may not open or close properly. Blood may leak in the wrong direction (valve regurgitation). This can cause swelling in the ankles and legs, palpitations, shortness of breath, and chest tightness.

• Hyperthyroidism: This is when the thyroid gland produces too much thyroid hormone. This condition can cause restlessness, increased appetite, rapid heartbeat, and weight loss.

• Hypertrophic cardiomyopathy: This is a type of heart disease that causes the heart muscle to become enlarged, thickened, or stiff. It can be inherited, or it can develop with age or due to high blood pressure. Other symptoms may include fainting (syncope), chest pain, palpitations, fatigue, and shortness of breath.

What are the symptoms of a `(Heart Murmur)`?

Some ``Heart Murmurs'' do not show any symptoms. They are identified during a routine medical examination.

However, depending on the cause of the murmur, you may experience symptoms such as:

• Blue skin (especially lips and fingertips)
• A persistent cough
• Feeling your heart beating fast (palpitations)
• Chest pain or tightness
• Difficulty breathing
• Sudden loss of consciousness (syncope) or a feeling of faintness

How does a doctor recognize a ``Heart Murmur''?

A doctor will listen to your heart to check for a ``Heart Murmur''. If there is a murmur, you will hear an unusual sound, like the 'whoosh' or 'swish' I mentioned.

The doctor will place the stethoscope on different parts of your chest and back to listen to your heartbeat. They will pay special attention to these things:

• Do you hear any other sounds besides the 'lub-dub' sound?
• What is the sound like? (`Pitch`)
• Heartbeat rhythm (`Rhythm`)
• At what point in the heartbeat is the sound heard? (`Timing`)
• How loud is the sound? (`Volume`)

Do you remember how the doctor sometimes tells you to do things while listening with a stethoscope? That's what it's for. For example:

• They say to shake hands.
• He tells me to sit down.
• He tells me to stand up from sitting down.
• He tells me to lie down on the ground.

What tests will the doctor do if he hears a ``Heart Murmur''?

If your doctor hears a murmur, they will need to do more tests to determine if it is caused by a health problem. You may be referred to a cardiologist.

The following tests can be done to find the cause of a ``Heart Murmur``:

• Chest X-ray: This takes pictures of the inside of the chest to check for structural problems in the heart or lungs.
• Echocardiogram (or echo): This is like an ultrasound scan of the heart. It uses sound waves to make pictures of the heart's valves and chambers. It also helps to check how well the heart is pumping blood. This can be a scan done through the skin, or a transesophageal echocardiogram, which uses a special instrument through the mouth and throat. This can produce clearer pictures of the heart.
• Electrocardiogram (ECG or EKG): This is a painless test that measures the electrical activity of your heart. It can detect problems with your heart rhythm and signs of a heart attack.

How to treat a `(Heart Murmur)`?

Most `(Heart Murmur)` do not require any treatment. And there is nothing to worry about them. Especially those `innocent' murmurs.

However, if a murmur is caused by a serious condition, you may need treatment like this:

• Medications: For example, iron pills for anemia, or medications to reduce thyroid function.
• Surgery: Sometimes surgery is needed to repair a heart valve or to replace it with a new one.

The most important thing is for the doctor to examine the patient thoroughly and determine the cause of the murmur and whether or not it requires treatment.

Can Heart Murmur be prevented?

There is really no way to prevent a ``Heart Murmur'' from occurring. Because some are congenital, while others are caused by other diseases.

However, you can take care of your heart health. Getting regular checkups and living a healthy lifestyle (eating well, exercising, and not smoking) can go a long way toward reducing the risk of serious problems caused by heart disease.

What is the health status of someone with a `(Heart Murmur)`?

This depends entirely on the cause of the murmur. 'Innocent' murmurs in young children often go away as they get older. Murmurs that occur during pregnancy usually go away after delivery.

However, murmurs related to heart conditions definitely require medical attention. That's why if a doctor tells you that you have a murmur, you should investigate it thoroughly.

When should I see a doctor?

If you have any of these symptoms that you think may be related to heart disease, you should seek medical advice immediately :

• If the skin turns blue (especially around the lips and nails)
• If you feel chest pain or pressure
• If you feel your heart beating abnormally (palpitations)
• If you have difficulty breathing
• If you suddenly faint (syncope) or feel light-headed

If you have any of these symptoms, don't ignore them. It's best to see a doctor as soon as possible and get checked out.

Let us remember these points (Take-Home Message)

Okay, so, to summarize what we've been talking about, a heart murmur is a 'whoosh' or 'swish' sound that you hear when blood flows abnormally through the valves of your heart.

Most of the time, these are 'innocent' murmurs, meaning they are not caused by any illness and are nothing to be afraid of. They are very common in young children.

However, some murmurs can be caused by a heart condition or other health problem. Therefore, it is very important to have any ``Heart Murmur`` examined by a doctor to find out the exact cause.

If a doctor tells you or your child that they have a ``Heart Murmur,'' don't panic, but listen carefully to what they have to say. By getting the necessary tests and getting the right treatment for the cause (if necessary), you can stay healthy.

Remember, your heart is your property! It is your responsibility to take good care of it.

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