Are you hearing a strange 'soo... soo...' sound from your heart? It could be a systolic heart murmur!

When your doctor places a stethoscope on your chest during a routine checkup, they listen closely to your heartbeat. Sometimes, along with the normal "lub-dub" sound, they might hear a gentle "whoosh" or whistling noise. This is called a heart murmur. Hearing that you have a murmur can feel scary, but many murmurs are completely harmless.

Today, we will talk all about one specific kind of murmur known as a systolic heart murmur. We will break down what it means, why it happens, and what you can do to keep your heart healthy and strong.

What is a Systolic Heart Murmur?

Simply put, a systolic heart murmur is an unusual sound that happens when your heart contracts. This is when your heart pumps blood out to the rest of your body. Doctors call this part of the heartbeat cycle systole. When you check your blood pressure, the top number represents this exact systolic pressure.

How Does Heart Sound Work?

Your heart has four special valves. These valves act like tiny doors that make sure blood flows in only one direction. When your heart beats, you hear a "lub-dub" sound. That noise is actually the sound of your heart valves snapping shut.

• The first sound ("lub"): This happens when the mitral and tricuspid valves close. These are also called the atrioventricular valves. This is when your heart begins to squeeze.
• The second sound ("dub"): This happens when the aortic and pulmonic valves close. These are known as the semilunar valves. This is when your heart gets ready to fill up with blood again.

A systolic murmur is an extra "whoosh" or "hiss" sound that happens right along with or right after that first "lub" sound. The main reason for this noise is turbulent blood flow inside your heart. It is very similar to the noise water makes when a garden hose gets partially pinched.

Most of the time, these murmurs are not dangerous at all. However, they can sometimes signal an underlying heart condition. That is why finding out why you have a murmur is so important.

What Are the Main Types of Systolic Murmurs?

Doctors generally sort these murmurs into two main groups:

• Functional Murmurs: People with this type have no structural defects in the heart. Their heart shape and valves are completely normal. These are usually innocent murmurs.
• Organic Murmurs: People with this type have a murmur caused by a physical problem inside the heart. This means a valve or a heart wall might have a structural flaw.

Doctors also divide systolic murmurs into two specific categories based on how blood moves:

• Ejection Murmurs: These usually start at the semilunar valves. These valves send blood from your heart to the aorta and the pulmonary artery. An ejection murmur happens when blood pushes out of your heart. These can be functional or organic.
• Regurgitant Murmurs: These happen when your heart valves do not close tightly, causing blood to leak backward. This is much like a water tap that leaks because it is not closed all the way. These usually start at the atrioventricular valves. Every regurgitant systolic murmur belongs to the organic group, meaning a structural flaw is present.

Systolic vs. Diastolic Murmurs: What is the Difference?

Both terms describe unusual sounds heard in the heart.

• Systolic Murmur: This sound occurs when the heart muscle squeezes at the start or during the heartbeat.
• Diastolic Murmur: This sound occurs when the heart muscle relaxes in the pause between two heartbeats.

Simply put, a systolic murmur happens when your heart is working hard. A diastolic murmur happens when your heart is resting.

Innocent vs. Abnormal Heart Murmurs.

Knowing the difference between these two types is very helpful.

• Innocent Heart Murmur: Sometimes, a murmur is not a sign of heart disease. Doctors call these innocent heart murmurs. They often appear in young children, pregnant women, or people with a fever or after heavy exercise. They usually need no treatment and fade away on their own.
• Abnormal Heart Murmur: On the other hand, some murmurs point to an underlying heart problem. Doctors call these abnormal heart murmurs. If you have an abnormal murmur, you will need to find the cause and get proper care.

Do not panic! Hearing that you have a murmur does not mean you have a serious illness. Your doctor can help figure out if it is innocent, normal, or needs attention.

What Are the Symptoms of a Systolic Murmur?

Many people with a heart murmur have zero symptoms at all. However, depending on what causes the murmur, you might notice signs like:

• A bluish color on your skin, especially around your lips and fingernails.
• A stubborn, ongoing cough.
• Sudden fainting spells, also called syncope.
• Feeling tired and worn out very quickly.
• Swelling in your legs and feet, known as edema.
• Feeling lightheaded or dizzy.
• Trouble breathing, known as dyspnea, especially when you exercise or lie down flat.

If you notice any of these signs, seeing a doctor is very important.

What Causes a Systolic Heart Murmur?

Many different issues can cause a murmur. Ejection murmurs and regurgitant murmurs have their own specific causes.

Causes of Ejection Murmurs:.

• Aortic Stenosis: This is a narrowing of your main heart valve, the aortic valve. It sends blood from your heart to your whole body. When it narrows, the door does not open fully, making it hard for blood to push through.
• Atrial Septal Defect (ASD): This is a small hole in the wall between the two upper chambers of your heart.
• Hypertrophic Obstructive Cardiomyopathy (HOCM): This is an inherited heart condition. The wall between your two lower heart chambers grows too thick.
• Pulmonic Stenosis: This is a narrowing of the valve that sends blood from your heart to your lungs.

Causes of Regurgitant Murmurs:.

• Mitral Valve Regurgitation: Normally, your mitral valve stays shut when your heart squeezes. In this condition, the valve does not close tightly. Some blood leaks backward into your upper left heart chamber.
• Tricuspid Valve Regurgitation: This is similar to mitral regurgitation, but it happens on the right side of your heart at the tricuspid valve. Blood leaks backward from the lower right chamber into the upper right chamber.
• Ventricular Septal Defect (VSD): This is a hole in the wall between your two lower heart chambers. It is a common birth defect seen in children.

How Do Doctors Diagnose a Systolic Murmur?

Doctors usually first find a murmur when listening to your heart with a stethoscope. When checking this sound, your doctor looks at several details:

• How long does the sound last?
• Where on your chest is the sound loudest?
• What is the pitch and volume of the sound? Is it soft or loud?
• Does the sound change when you move your body, such as lying down or standing up?

Will You Need More Tests?

Yes. If your doctor wants more details about your murmur, they may send you to a heart specialist called a cardiologist. You might have tests such as:

• Cardiac Catheterization: A doctor guides a tiny, flexible tube through a blood vessel from your groin or arm up to your heart. They use special dye and X-rays to check how well your blood flows.
• Chest X-ray: This takes a picture of your bones, heart, and lungs.
• Echocardiogram (Echo): This test works much like an ultrasound used during pregnancy. It uses sound waves to show how your heart moves, how your valves work, and how large your heart is. This test is vital for finding the root cause of a murmur.
• Electrocardiogram (EKG/ECG): This records the electrical signals in your heart. It helps check for any heart rhythm issues.

Is There a Grading Scale for Systolic Murmurs?

Yes. Doctors grade murmurs based on how loud and strong they are using a scale from 1 to 6.

• Grade 1: Very faint and hard to hear. Only an experienced doctor can usually spot it.
• Grade 2: Soft, but you can hear it right away once the stethoscope touches your chest.
• Grade 3: Moderately loud and easy to hear.
• Grade 4: Quite loud. If you place your hand on the chest, you can feel a distinct vibration, called a thrill.
• Grade 5: Very loud. You can hear it even if you barely touch your stethoscope to the chest. The vibration is also easy to feel.
• Grade 6: Extremely loud. You can hear it even without touching the stethoscope directly to your chest.

This grading helps doctors understand how serious the murmur might be.

How Do Doctors Treat a Systolic Heart Murmur?

Your treatment plan depends entirely on whether your murmur is innocent or if an abnormal heart condition causes it.

For Innocent Murmurs:.

These usually go away on their own without any treatment. Your doctor may simply want to watch it and check your heart again later.

For Abnormal Murmurs:.

Treatment focuses on managing the underlying heart problem. This can involve medicines, surgery, or both.

medicines:.

• ACE Inhibitors: Medicines like Captopril or Benazepril help lower your blood pressure.
• Beta-Blockers: Drugs like Metoprolol or Bisoprolol help lower your heart rate and blood pressure.
• Blood Thinners: medicines like Warfarin or Aspirin help prevent dangerous blood clots inside your heart.
• Diuretics: Drugs like Furosemide or Torsemide help your body get rid of extra fluid, which helps with certain heart conditions.

Surgeries:.

If your heart condition is serious, you might need surgery to fix or replace a valve.

• Valve Repair: This helps widen a narrow valve or tighten a leaky valve so it closes properly.
• Valve Replacement: If a valve is badly damaged or narrow, your doctor can replace it with a tissue valve or a mechanical valve.
• Open Heart Surgery: Surgeons sometimes need to perform open-heart surgery to close holes in the heart walls, such as an ASD or VSD.

Can You Prevent a Systolic Heart Murmur?

You cannot always prevent a systolic heart murmur because some are present at birth while others develop due to illness. However, you can take steps to keep your overall heart health in great shape:

• Get at least 150 minutes of good aerobic exercise every week, like walking, running, or cycling.
• Eat a healthy diet rich in whole grains, fruits, and vegetables.
• Limit caffeine like tea and coffee, and cut back on alcohol.
• If you smoke, quit smoking completely.
• Lower your stress levels with helpful habits like meditation.
• Get 7 to 8 hours of good sleep every night.

What Does the Future Look Like with a Systolic Murmur?

If you have an innocent systolic murmur, you will likely need no treatment and can live a completely normal life.

If you have an abnormal murmur, you will need treatment for the underlying heart condition. Fortunately, modern medical treatments make it very possible to manage many heart conditions and enjoy a healthy, active life. Sticking to a healthy lifestyle also gives your heart extra strength.

Questions to Ask Your Doctor.

If your doctor tells you that you have a systolic murmur, here are some helpful questions to ask during your visit:

• What is the most likely cause of my systolic heart murmur?
• Do I need any extra medical tests?
• Do I need treatment for this murmur?
• What treatments are available for my specific heart condition?
• Would seeing a cardiologist help me manage this?
• What lifestyle changes can I make to protect my heart health?

The most important thing is not to panic. If your doctor finds a murmur, you can find out what kind it is and what steps to take. Following medical advice and keeping a healthy lifestyle will help you live an active life. Remember that taking care of your heart is one of the best things you can do!