Are you hearing a strange "soo... soo..." sound coming from your heart? It could be a Systolic Heart Murmur!

When a doctor listens to your chest with a stethoscope, sometimes you may hear a small 'swoosh' or 'whistle' sound in addition to the normal 'lub-dub' sound of your heart. This is what we call a 'heart murmur'. Some people get scared when they hear this, but not all murmurs are dangerous. Today we are going to talk about one such murmur , the Systolic Murmur .

What is a Systolic Murmur?

Simply put, a systolic heart murmur is an abnormal sound that you hear when your heart contracts, that is, when it pumps blood around your body. Doctors call this the systole of the heart. When you look at your blood pressure, the top number is the systolic pressure.

How is the heart sound produced?

Our heart has four valves. These are like doors that allow blood to flow only in one direction. When the heart beats, the 'lub-dub' sound is heard as these valves close.

• First sound ('lab'): This occurs when the mitral and tricuspid valves (also called the atrioventricular valves ) close. This is when the heart begins to contract (systole).
• Second sound ('dub'): This occurs when the aortic and pulmonic valves (also called semilunar valves ) close. At this time, the heart is getting ready to fill with blood again.

A systolic murmur is an additional 'swoosh' or 'whoosh' sound that is heard with or after the first 'lub' sound. The main cause of this is turbulent blood flow within the heart. It's like the sound of a clogged water pipe.

Although these murmurs are usually not dangerous, they can sometimes be a sign of an underlying heart condition. So if your doctor tells you that you have a murmur, it's important to get it checked out.

What are the main types of systolic murmur?

Doctors divide these murmurs into two types:

• Functional Murmurs: These people have no structural defects in the heart, meaning there is no problem with the shape of the heart or the valves. These are often innocent murmurs.
• Organic Murmur: These people have a murmur due to a structural problem in the heart. This means there may be a defect in a valve or in the heart wall.

These systolic murmurs are also classified in another way:

• Ejection Murmurs: These usually start with the semilunar valves we talked about earlier. These valves are what carry blood from the heart to the aorta and pulmonary artery to the lungs. An ejection murmur is a sound made when blood is pushed out of the heart, or 'ejected'. These can be functional or organic.
• Regurgitant Murmurs: These occur when the heart valves do not close properly, causing blood to leak backwards. It's like a water faucet not closing properly. They usually start in the atrioventricular valves. All regurgitant systolic murmurs are organic , meaning there is some structural defect.

What is the difference between a systolic and a diastolic murmur?

Both of these are abnormal heart sounds.

• Systolic murmur: This is heard when the heart muscle contracts (at the beginning or during a heartbeat).
• Diastolic murmur: This is heard when the heart muscle is resting (between two heartbeats).

Simply put, systolic is the sound that comes when the heart is 'working', and diastolic is the sound that comes when the heart is 'resting'.

What is the difference between an innocent and an abnormal heart murmur?

This is also very important.

• Innocent Heart Murmurs: Sometimes this murmur is not a sign of heart disease. This is what doctors call an 'innocent heart murmur.' These are usually seen in young children, pregnant women, or during conditions such as fever or after heavy exercise. Most of the time, this does not require treatment and will go away over time.
• Abnormal Heart Murmurs: On the other hand, some murmurs are a symptom of an underlying heart condition. These are called 'abnormal heart murmurs.' If you have an abnormal murmur, the cause will need to be found and treated.

Don't panic! You don't need to panic when a doctor tells you that you have a murmur. You can find out if it's harmless or not, or if there's something wrong with it.

What are the symptoms of a systolic murmur?

Many people with a heart murmur may not experience any symptoms. However, depending on the cause of the murmur, you may experience symptoms such as:

• A blue tinge to the skin (especially the lips and fingernails).
• A persistent cough.
• Sudden fainting (syncope) .
• Feeling tired quickly.
• Swelling of the legs, fluid retention (edema) .
• Feeling dizzy (vertigo).
• Difficulty breathing (dyspnea) , especially when exercising or lying down.

If you have these symptoms, it is very important to see a doctor.

What causes a systolic heart murmur?

There can be several reasons. The ejection murmur and regurgitant murmurs we discussed earlier have different causes.

Causes of Ejection Murmurs:

• Aortic stenosis: This is a narrowing of the main valve that carries blood from the heart to the entire body (aortic valve), like a door that can't open properly. This causes a blockage in the flow of blood.
• Atrial septal defect (ASD): A small hole in the wall between the two upper chambers (atria) of the heart.
• Hypertrophic obstructive cardiomyopathy (HOCM): This is a genetic heart disease in which the wall (septum) between the two lower chambers (chambers) of the heart becomes abnormally thick.
• Pulmonic stenosis: Narrowing of the valve that carries blood from the heart to the lungs (pulmonic valve).

Causes of regurgitant murmurs:

• Mitral valve regurgitation: Normally, the mitral valve should be closed when the heart contracts (during systole). However, in this condition, the valve does not close properly, allowing some blood to leak backward into the left atrium.
• Tricuspid valve regurgitation: This is similar to mitral regurgitation, but it occurs in the tricuspid valve on the right side of the heart. Blood leaks backward from the right ventricle into the right atrium.
• Ventricular septal defect (VSD): A hole in the wall between the two lower chambers (ventricles) of the heart. This is a common birth defect in young children.

How do you recognize a systolic murmur?

This murmur is often first heard when your doctor listens to your heart with a stethoscope. When a doctor is looking for this sound, they will look for the following:

• How long can you hear the sound?
• Where exactly in the heart does the sound come from?
• How is the pitch and volume of the sound ? (Does it sound soft or loud?)
• Does the sound change when you change positions (e.g., lying down, standing up)?

Will further tests be needed?

Yes, if your doctor wants to know more about the murmur, he or she may refer you to a cardiologist, who may perform tests such as:

• Cardiac catheterization: In this procedure, a small, flexible tube (catheter) is inserted through the groin or arm, guided through the arteries of the heart, and the condition of the arteries is examined using X-rays and a special liquid (contrast dye).
• Chest X-ray: This takes pictures of the bones, heart, and lungs.
• Echocardiogram (Echo): This is like an ultrasound scan of a baby in the womb. It uses sound waves to see things like how the heart is beating, how the valves are working, and the size of the heart. This is a very important test to find the cause of a murmur.
• Electrocardiogram (EKG/ECG): This records the electrical activity of the heart. It can check for heart rhythm problems.

Is there a systolic murmur grading scale?

Yes, doctors grade a murmur based on its intensity. There is a scale for this from 1 to 6.

• Grade 1: A very quiet, barely audible murmur. Only an experienced doctor can detect it.
• Grade 2: A soft murmur, but audible with a stethoscope.
• Grade 3: Moderately loud.
• Grade 4: It is quite loud, and you may feel a thrill if you press your hand against your chest.
• Grade 5: Very loud. You can hear it even if you just put the stethoscope on your chest and listen. You can also feel a vibration.
• Grade 6: A very loud murmur. Loud enough to be heard even with the stethoscope not placed on the chest, or even slightly closer.

This rating can give you some idea of ​​the severity of the murmur.

How is a systolic heart murmur treated?

The treatment depends on whether the murmur is innocent or abnormal due to an underlying heart condition.

For the innocent Marmer:

These often go away without treatment. The doctor will tell you to just wait and see, and maybe check back in a while.

For unusual murmurs:

This requires treatment for the underlying heart condition, which may require medication, surgery, or both.

Medications:

• Angiotensin-converting enzyme (ACE) inhibitors: For example, Captopril and Benazepril. These lower blood pressure.
• Beta-blockers: For example, Metoprolol, Bisoprolol. These reduce heart rate and blood pressure.
• Blood thinners: For example, Warfarin, Aspirin. These prevent blood clots from forming inside the heart.
• Diuretics: For example, Furosemide, Torsemide. These reduce the amount of excess fluid in the body. This can help with some heart conditions.

Surgery:

If the heart condition is severe, it may be necessary to repair the valve, insert a new valve, or undergo other surgery.

• Valve repair: This can be used to enlarge (open) a narrowed valve or tighten a leaking valve that is not closing properly.
• Valve replacement: If a valve is too narrow or damaged, the doctor may replace it with a tissue valve or a mechanical valve.
• Open heart surgery: Sometimes, open heart surgery is required to close holes, such as the atrial septal defect (ASD) or ventricular septal defect (VSD) we talked about.

Can a systolic heart murmur be prevented?

There is no specific way to prevent a systolic murmur. Some are congenital, while others are caused by other conditions. However, it is important to maintain the overall health of your heart. Here are some things you can do to help:

• Do at least 150 minutes of aerobic exercise per week (such as walking, running, or cycling).
• Eat a healthy diet rich in grains, fruits, and vegetables.
• Limit caffeine (tea, coffee) and alcohol.
• If you smoke, you need to stop .
• Reduce stress through things like meditation.
• Get at least 7-8 hours of good sleep a night.

What is the outlook for someone with a systolic murmur?

An innocent systolic murmur often does not require treatment, and you can live a normal life with it.

If you have an abnormal murmur, you will need to treat the underlying heart condition. However , with advanced treatments available today, you can control many heart conditions and live a healthy life. Also, following a healthy lifestyle can help improve your heart health.

Don't forget to ask the doctor about these things, okay?

If your doctor tells you that you have a systolic murmur, it's a good idea to ask these questions:

• What is the most likely cause of this systolic murmur in me?
• What additional tests do I need to do?
• Do I need treatment for this systolic murmur?
• What treatment do I need for my underlying heart condition?
• Would it be beneficial for me to see a cardiologist ?
• What lifestyle changes can I make to improve my heart health?

Take-Home Message

A systolic heart murmur is an abnormal sound heard when the heart contracts. Most of the time, these are harmless, meaning there is no underlying heart disease. But sometimes, they can be a sign of a heart condition.

The most important thing is not to panic. If a doctor tells you that you have a murmur, you can find out what kind it is, what is causing it, and whether or not treatment is needed. By following proper medical advice and living a healthy lifestyle, you can live an active life. Remember, taking care of your heart is very important!

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