A heart 'murmur' is a sound heard by a doctor when listening to
the heart with a Stethoscope. It occurs between, or in addition to,
the normal 'heart sounds' and results from some turbulence
('eddies') resulting from the flow of blood through, or close to,
the heart. Murmurs are sometimes described as "whooshing noises"
produced with each heart beat.
Whilst some murmurs can indicate the presence of a heart
abnormality the commonest murmurs are not due to any heart problem
at all. These so-called 'Innocent murmurs' are detected in many
normal children. They result from minor turbulence in the flow of
blood, which occurs in entirely healthy children and even in
adults. Such murmurs are often found during a routine examination,
either in infancy or later in childhood. They can also be found in
Innocent murmurs are often rather louder, and hence more easily
detected, during an illnesss associated with a raised temperature
(fever). As the heart works harder when the body temperature is
high this makes the turbulence in blood flow increase and the
murmur is louder.
If a doctor detects a heart murmur, during an illness when the
child has a temperature, he will often ask to see the child again
after an interval (e.g. when the temperature has returned to
normal). This makes it easier for him to decide whether the murmur
is normal / innocent.
If a doctor has picked up a murmur and is unsure as to whether
it is normal or whether it may be associated with a heart problem
he may arrange some tests or ask another doctor to examine the
child. Simple, but useful, tests to try to make sure whether the
heart is normal include an Xray of the chest to check whether the
heart is enlarged or whether there is any evidence of an
abnormality in the appearance of the lungs (which can be due to
some heart problems) and an electrocardiogram (ECG). This (the ECG)
allows the electrical activity of the heart to be examined, which
often indicates whether the heart is under any stress or strain, if
an abnormality is present.
Often a Paediatrician will examine the child and may be able to
confirm that the murmur is 'innocent', in which case no further
checks may be needed. If there is any continuing uncertainty, or if
the doctor or the parents are anxious about the issue, then a
consultation with a paediatric cardiologist (childrenís heart
specialist) may be helpful.
An ultrasound examination of the heart (Echocardiogram) may
sometimes be organised, if a heart defect is suspected, but is not
usually necessary when the murmur is clearly ëinnocentí. The
echocardiogram (if required) is painless and takes about half an
hour. Some younger children will require sedation for this
examination to be performed.
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