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Heart Murmurs

“Murmur” is simply a name given to an extra sound we hear when listening to someone's heart. A murmur heard in a child or young adult most often means something completely different than a murmur heard in an older adult. In children, a murmur most often results from the way that blood is flowing through an otherwise normal heart. There are several names given to this type of murmur: “innocent”, “functional”, “physiologic” murmur, all of which means that the structure/make-up of the heart is normal.

There are other times, however, when the murmur results from something abnormal in the heart, like a hole between one of the walls of the heart, or a problem with one of the valves of the heart. Such a hole, or problem with one of the valves changes the way that blood flows through the heart. The blood flow becomes “turbulent”, which means that the blood flow is no longer smooth but becomes rocky (think of water flowing into a lake versus water flowing down Niagra Falls). This “turbulence” causes vibrations that produce a sound that we hear with our stethoscope. Sometimes, if bacteria infects someone's blood, it may collect on the heart valves, causing them to become stiff or leaky. This changes the way that blood flows through the heart and creates the sound we call a murmur.  Most often, we can tell whether or not a murmur is normal, or pathologic (“not normal”) just by listening with our stethoscope.

However, our ears aren't 100% effective, so we often perform a few simple tests called an electrocardiogram and echocardiogram. The “-cardiogram” part refers to the heart. Electrocardiograms give us information about the rhythm of the heart and the electrical activity of the heart. Echocardiograms give us information about the structure of the heart. Echocardiograms use ultrasound waves to take pictures of the heart, including the walls of the heart, all four heart valves, the heart muscle, etc. In adults, a murmur may still be normal, but may also result from a problem with one of the valves of the heart or with the overall function of the heart. If we eat a diet high in fat and cholesterol, we develop plaques in the blood vessels of the heart, including plaques that coat the heart valves, causing them to become stiff and not work as properly. This changes the way that blood travels through the heart and causes the sound we call a murmur. Adult cardiologists evaluate adults with heart murmurs in much the same way, using electrocardiograms and echocardiograms, although may sometimes use a CAT scan (to look for those plaques in the blood vessels) or even a stress test (to see if the heart is functioning properly during exercise). 


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Children's Heart Institute

P. O. Box 10066 McLean, VA 22102

Central Registration (patient appointments):

phone - 703-481-5801

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phone - 571-612-2600 /  fax - 571-266-4096