Have you ever heard a doctor say, "I can hear a little heart murmur" when they put a stethoscope to your chest? You've probably heard it yourself. Many people get scared when they hear this "murmur." It's normal to think, "Is there something wrong with my heart?" But don't be afraid. Today, we'll talk about what a Holosystolic Murmur is, why it occurs, and what can be done about it.
Simply put, what is this Holosystolic Murmur?
Imagine water flowing smoothly through a water pipe without any obstruction. Then you don't hear any sound. But if there is a small blockage or hole somewhere in the pipe, when the water flows, it makes a strange sound like a 's...'. That's how it is.
Holosystolic Murmur is not a disease. It is a sign . When your doctor listens to your heart with a stethoscope, it is an additional sound that is heard in addition to the 'lub-dub' sound of your heart beating, because the blood is not flowing smoothly. To be precise, this sound is heard continuously during the contraction (systole) of the heart and is therefore called a Holosystolic (heard throughout the entire contraction) Murmur.
The most important thing is that it's not the presence of this murmur that is dangerous, it's the underlying condition that is causing it that we need to find and treat.
Your doctor will probably tell you to give this sound a number (from 1 to 6). This only tells you how loud the sound is. A higher number does not mean it is more dangerous. Sometimes when the doctor puts his hand on your chest, this sound feels like a shock. It is also called a 'thrill'.
What are the main reasons for this noise?
You know that our heart has four chambers. Between these chambers there are things like doors that help blood flow in only one direction. We call them 'valves'. If these valves don't close properly, blood starts to leak back. That's when this murmur is mainly heard.
| Main reason | Simply explained |
|---|---|
| Mitral Regurgitation | This is when the mitral valve on the left side of the heart does not close properly, allowing blood to leak backward. This valve can be damaged by conditions such as rheumatic fever. |
| Tricuspid Regurgitation | This occurs when the tricuspid valve on the right side of the heart does not close properly, causing blood to leak backward. |
| Ventricular Septal Defect (VSD) | This is a hole in the wall between the two main chambers (ventricles) at the bottom of the heart. This is often a congenital condition. A murmur is heard as blood flows through this hole. |
What happens with this?
Imagine, in a person with Mitral Regurgitation, the mitral valve doesn't close properly, causing blood to flow back in the direction it came from the lungs. This increases pressure in the veins leading to the lungs, and in severe cases, the lungs can fill with fluid. Over time, this can lead to heart failure.
How is it treated?
As I said before, we don't treat the murmur, but the underlying condition that's causing it . Your doctor will first do tests (for example, an echocardiogram , which is a scan of the heart) to see what's causing it.
- If blood leaks from the valves (Regurgitation):
- Medications: Medications such as anticoagulants or diuretics may be given.
- Surgery: If medication alone is not enough, surgery may be required to repair the damaged valve or to replace it with a completely new valve.
- If there is a hole in the heart (VSD):
- Medication can be given to control symptoms.
- Often, surgery is performed to close this hole.
- If the valve is narrowed (Stenosis):
- Sometimes, a murmur can also be caused by a narrowing of the valve. In such cases, a procedure called Balloon Valvuloplasty is used. A balloon is passed through a vein through a procedure called cardiac catheterization and inflated inside the narrowed valve, widening the valve.
What if a new heart valve is inserted?
There are two types of new valves.
| Valve type | What to know |
|---|---|
| Mechanical | These are made of metal and plastic. They last a long time. But you have to take anticoagulants for the rest of your life. |
| Bioprosthetic (biological) | These are made from pig or cow heart tissue. They last about 10-15 years. But you don't need to take anticoagulants for the rest of your life. |
| Things to keep in mind when installing either of these two types of valves: | |
| |
What are the symptoms that require seeing a doctor?
Some people have a murmur but no symptoms. They may not even know they have it. But for some people, the underlying cause may cause bothersome symptoms. If you experience any of these symptoms, see a doctor right away.
- Difficulty breathing
- Chest pain or a feeling of tightness
- Feeling like your heart is beating fast (palpitations)
- Shortness of breath (dyspnea)
- Swelling, especially in the legs, ankles, and feet
If you go for regular medical checkups, your doctor can detect this condition early. It's best to detect any illness before it gets worse.
Take-Home Message
- Holosystolic Murmur is not a disease, it is just a sign that there is something wrong with your heart.
- The main causes of this are blood leaking backward from the heart valves (regurgitation) or a hole in the wall of the heart (VSD).
- The treatment is not for the murmur, but for the underlying medical condition that is causing it.
- If you have symptoms like difficulty breathing, chest pain, or swelling in your legs, don't ignore them and see your doctor immediately .
- By undergoing timely medical examinations, conditions like these can be identified early and treatment can be initiated before they become severe.
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