• The Heart House


Innocent Causes:


During fever the blood flows faster to meet the body's higher energy needs, this is similar to a fast flowing stream. This murmur could be heard in any child with fever and disappears when the fever is over.



When the concentration of red blood cells is low, as may happen with poor nutrition, the blood will flow faster, making a murmur. This murmur resolves after treating the anemia.



 Thin chest wall and a straight back

Simply because the heart is closer to the chest wall, the blood flow sound will be easily heard without indicating there is anything wrong with the heart.

Venous Hum

Venous hum is a common innocent murmur heard during childhood. This murmur is heard as a soft humming sound at the base of the neck just above the collarbone. It results from the normal blood flow in the large neck veins (jugular veins).

The doctor may lightly compress the neck vein to make the murmur transiently disappear, or he may turn your child's head to one side or another, so as to make the murmur sound louder. These simple maneuvers help the doctor to differentiate a Venous Hum from the murmurs resulting from heart disease.



Still's Murmur

This heart murmur is named after the doctor who described it. It is heard most frequently in active, healthy 3 to 7-year old children. The murmur represents the normal sound of blood gushing out into the aorta during heart contraction.

It has a musical tone to it and thus is frequently described as "musical murmur"; it usually sounds softer during sitting and may sound very loud during fever, anxiety, or exercise.


Not-Innocent Causes:

A Narrow Valve

If you press on your garden hose, the sound of the flowing water becomes louder, as the caliber of the garden hose becomes narrower.

As the blood encounters a narrowed valve it becomes turbulent, and faster to squeeze itself through, thus producing a heart murmur.


A narrow valve is called valve stenosis. The importance of the situation depends on what valve is involved and the degree of the narrowing.


A Leaking Valve

As the heart valve closes some blood leaks back making a blowing sound (murmur). A leaking valve is called insufficient or regurgitating. Its importance depends on how much blood is leaking, what valve is involved, and how long it has been going on.


A Hole in the Heart

Because the pressure in the heart chambers is not the same, the blood will flow from the high to the low-pressure chamber, producing a murmur sounding like a waterfall. If the hole is small, it will make a very loud sound. If the hole is large it may make a faint murmur that may go unnoticed for some time; therefore a faint murmur may sometimes indicate a serious problem.

A hole in the heart is called septal defect. If it is between the upper cardiac chambers, it is called Atrial Septal Defect (ASD), and is called Ventricular Septal Defect (VSD) if it is between the lower cardiac chambers. The importance of septal defects depends on their size and site.






A Narrow Artery

If the arteries going to the lungs from the heart (Pulmonary Arteries) are narrow they may produce a heart murmur. This is a defect called Branch Pulmonary Artery Stenosis.

To learn more about Branch Pulmonary Artery Stenosis, click here.




Small Hole


Large Hole

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Children's Heart Institute

P. O. Box 10066 McLean, VA 22102

Central Registration (patient appointments):

phone - 703-481-5801

Billing Inquiries:

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