Heart murmur: what it is, types, and associated diseases
A heart murmur refers to the presence of an unusual, additional sound heard during a heartbeat. It is described as hissing, squeaky, or harsh.
So while most heart murmurs are harmless (especially if they occur in children), in some patients, may be a sign of a heart problem or other underlying health condition serious. In these cases, treatment may be needed to keep the heart healthy.
The presence of heart murmurs is more common than we think, according to the latest studies, heart murmurs affect up to 72% of children under 12 years of age. Generally, this noise disappears with the passage of time. Although, in some cases, this can remain until beyond adolescence. In addition, some pathological conditions, such as valve disease, are frequent causes of the onset of heart murmurs in adulthood. In this article We describe the two types of heart murmurs, their causes, and how they occur..
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What is a heart murmur?
The unusual sound caused by the passage of blood through the valves of the heart
is called a heart murmur. This occurs because the blood flow past the heart causes friction and turbulence in the vein. Most of the time, this has a harmless effect; however, in some cases it may be a sign of a more serious condition.This presence of an unusual sound is that of blood flowing in an unusual way. It may be, for example, that it passes through a heart valve that has some defect. Or due to the presence of a condition that causes the heart to beat faster than normal, forcing it to handle more blood.
A doctor listening to our heartbeat with the help of a stethoscope normally hears the typical sounds of blood flowing through the heart valves. If the sound is unusual or irregular, it is called a heart murmur.
A breath is, briefly stated, a sign that health professionals notice during cardiovascular examination. Health professionals examine the hearts of patients through different physical examination techniques. Heart murmurs differ from normal heart sounds in their characteristics, for example, they may have a different duration, rhythm, or pitch.
During a cardiovascular exam, doctors look for signs such as sounds or murmurs. The main technique of physical examination is cardiac auscultation, it requires good hearing capacity and allows to distinguish subtle differences in the pitch and duration of noises.
Hearing impaired professionals can use stethoscopes with amplification. Another exploration technique is palpation, this allows the vibrations called "thrill" or cardiac fremit to be detected by touch. These vibrations could be described as the sensation of rubbing that the hand perceives, comparable to the purring of a cat. Detection of cardiac "thrhills" always has pathological significance.
As we have seen, the detection of these important indicators can indicate the presence of different valvular conditions or pathologies, such as heart disease, in patients. Also, heart murmurs may be present at birth (congenital) or develop later in life (acquired).
There are many different types of murmurs, and they are helpful in determining signs of heart or vascular disease. Some heart murmurs are harmless; they are known as "innocent heart murmurs." However, some murmurs indicate an underlying heart problem and should be examined further by a specialist.
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Causes
The heart is divided into four chambers separated by valves. that adjust the amount of blood entering each chamber at one time. The valves also help the heart prevent the backflow of blood; they close and open to allow blood to flow through the heart's two upper chambers, called the atria, and the two lower chambers, called the ventricles.
A healthy heart makes a sound called a 'lub-dub' when it contracts and relaxes., alternatively an unhealthy one makes a muttering noise. The “lub” (systolic sound) occurs when cardiac muscle tissue contracts and the atrial valves (mitral and tricuspid) close. The “dub” (diastolic sound) occurs when the heart muscle tissue relaxes and the upper valves (aortic and pulmonary) close to prevent blood flow back. A heart murmur is the presence of an additional sound in the heartbeat, heard as a "whoosh."
The murmur is usually caused by turbulent blood flow through an abnormal heart valve. Although, alternatively, may be caused by a condition that causes the heart to beat faster and handle more blood.
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Heart murmur classification
There are a number of 7 main characteristics to classify murmurs:
- Time: refer to whether it occurs during contraction (systole) or relaxation (diastole) of the heart muscle.
- Shape: refers to the pattern of intensity. This can be constant, increasing, decreasing, or between increasing and decreasing.
- Location: refers to the place of the murmur where it occurs with greater intensity (epicenter), for example the second right intercostal space.
- Irradiation: refers to the place where the breath propagates. Sound normally propagates in the direction of blood flow.
- Intensity: refers to the power (intensity) of sound, murmurs are measured by how loud they sound into the stethoscope. These are classified according to the Levine scale that goes from 0 to 6.
- Tone: A murmur is described as a hissing, scratchy, or harsh noise. Depending on the tone, this noise can be classified as acute, intermediate, serious (low)
- Quality or Timbre: refers to other special characteristics that the murmur may have and help us to describe it, such as: soft or aspirative, blowing, resounding, musical...
types of heart murmurs
If a heart murmur is heard during a medical examination, the only thing we know is that there is turbulence in the blood as it passes through the heart valves.
A murmur, as such, does not entail the realization of any type of diagnosis, since it can occur for different reasons. reasons, these can be of a physiological nature, that is, not pathological, or be related to a problem doctor. Heart murmurs fall into two categories: innocent and abnormal.
What is an innocent heart murmur?
An innocent murmur is called a heart murmur that has no clinical or pathological repercussions for the patient; this is not related to any health problem. It can be congenital or manifest in adulthood, and does not require any type of treatment.
There are many situations in which the murmur occurs physiologically (not pathologically). Many healthy children have heart murmurs, and some pregnant women may also develop heart murmurs. during pregnancy, since the heart needs to pump more blood to feed the fetus. Also other conditions such as fever, anemia (lack of red blood cells), hyperthyroidism or intense physical exercise can be related to the detection of murmurs. Most innocent murmurs occur during the contraction of the heart (systole), which is why they are called systolic heart murmurs.
In general, these murmurs are considered harmless; they are not related to any other pathological condition or underlying cardiac problem. They may simply be a sign of faster-than-usual blood flow to the heart valves. Ultimately, people with these types of harmless heart murmurs do not need to make any lifestyle changes or seek treatment.
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What is an abnormal heart murmur?
In some cases, murmurs may be related to pathological problems. The heart can suffer from age, unhealthy habits, or other conditions that cause it to work harder than usual, which can damage or overload the heart valves. The murmur in this case is a sign that there is some damage to the heart valves, usually a narrowing or hardening. Also, some people may be born with a defective heart valve, either a defect in the structure or the presence of another abnormality. In these cases there are different treatments depending on the severity and extent of the injury.
The most common valve problems are:
- mitral valve prolapse
- Mitral or aortic valve stenosis
- aortic sclerosis and stenosis
- mitral or aortic regurgitation
- Congenital heart defects
Finally, heart murmurs are often not accompanied by any other signs and are only discovered at the time of a physical examination. When symptoms appear (usually shortness of breath or dizziness) they usually indicate an underlying condition, including valve damage.
