Decoding the Murmuring in Heart: A Comprehensive Guide to Heart Murmurs


The human heart is a remarkable organ, tirelessly pumping blood throughout the body’s blood vessels to sustain life. However, sometimes the rhythmic beating can be accompanied by unusual sounds, known as heart murmurs or an abnormal murmur. These murmurs are caused by turbulent blood flow or blood flowing through the heart’s chambers and valves, and they can provide valuable insights into potential cardiovascular disease or heart defects.

What is a Heart Murmur?

A heart murmur is an abnormal heart sound that can be heard during a heartbeat. It is typically described as a whooshing, swishing, rasping sound heard, or blowing noise that occurs between the normal lub-dub heartbeat sounds of the heart. Heart murmurs are not diseases themselves but rather indicators of underlying heart conditions, abnormalities like valvular heart disease, congenital heart defects, or other issues affecting blood flow through the heart.

Some murmurs, called innocent murmurs or innocent heart murmurs, are harmless and have no medical significance. These innocent murmurs are common in children and may disappear as they grow older. However, other murmurs can signal more serious problems, such as narrowed heart valves, holes in the heart (e.g., atrial septal defect, ventricular septal defect), or abnormal connections between blood vessel (e.g., anomalous pulmonary venous return).

Types of Heart Murmurs

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Heart murmurs can be classified into two main categories: innocent (harmless) murmurs and pathological (abnormal) murmurs.

  1. Innocent Heart Murmur: Innocent murmur or innocent heart murmurs are common and generally harmless. They are often heard in children and pregnant women and can be caused by various factors, such as increased blood flow, temporary changes in the heart’s structure, or an overactive thyroid gland. These murmurs, sometimes called murmur venous hum, typically do not require treatment and may resolve on their own over time.
  2. Pathological Murmurs: Pathological murmurs or abnormal heart murmurs are indicative of underlying heart conditions, heart defects, or abnormalities. They can be further classified based on their timing during the cardiac cycle (systolic murmur or diastolic murmur) and their location (valvular heart disease, septal defects, aortic valve, or vascular issues).

Causes of Heart Murmurs

Heart murmurs can arise from various underlying conditions, including:

  1. Valvular Heart Disease: Abnormalities in the heart valves, such as stenosis (narrowed heart valve) or regurgitation (leaky heart valve), can cause turbulent blood flow and lead to murmurs. Examples include aortic stenosis, mitral valve prolapse, and aortic regurgitation.
  2. Congenital Heart Defects: Certain congenital heart defects, like atrial septal defect, ventricular septal defect, or anomalous pulmonary venous return, can result in murmurs from birth due to abnormal blood flow patterns.
  3. Cardiovascular Diseases: Conditions like high blood pressure, aortic aneurysms, or heart failure can alter blood flow through the heart and blood vessels, potentially causing murmurs.
  4. Physiological Changes: Increased blood flow during pregnancy, anemia, fever, or hyperthyroidism (overactive thyroid) can sometimes produce temporary, innocent murmurs or murmur sounds.

Diagnosis of Heart Murmurs

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The diagnosis of heart murmurs typically begins with a physical examination, during which a healthcare professional uses a stethoscope to listen to the heartbeat sounds. Additional tests may be recommended to determine the underlying cause and severity of the murmur, such as:

  1. Echocardiogram (Ultrasound): This non-invasive imaging technique provides detailed visualizations of the heart’s structure and blood flows, allowing for the identification of any abnormalities or congenital heart defects.
  2. Electrocardiogram (EKG/ECG): This test records the electrical activity of the heart muscle contracts and can help detect any rhythm disturbances, arrhythmias, or signs of heart strain.
  3. Chest X-ray: X-ray imaging can reveal any structural abnormalities, enlargement of the heart’s chambers, or possible cardiovascular disease.
  4. Cardiac Catheterization: In some cases, this invasive procedure may be necessary to directly measure pressures within the heart and evaluate the extent of any blockages, valvular heart disease, or congenital heart defects.

Treatment and Management

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The treatment approach for heart murmurs depends on the underlying cause and severity of the condition. In some cases, no treatment may be necessary, especially for innocent murmurs or mild cases. However, in other instances, prompt medical intervention may be required to address the underlying issue and prevent potential complications like heart failure or blood clots.

  1. Medication: Depending on the cause, medications such as diuretics, blood thinners, or anti-arrhythmic drugs may be prescribed to manage symptoms, regulate heart rhythms, and reduce the workload on the heart.
  2. Surgical Intervention: For more severe cases, such as significant murmurs, valve disorders (e.g., acute mitral regurgitation), or congenital heart defects, surgical procedures like open heart surgery, valve repair or replacement, or correction of structural abnormalities may be recommended.
  3. Lifestyle Modifications: In certain cases, making lifestyle changes, such as maintaining a healthy diet, exercising regularly, managing stress levels, and controlling conditions like high blood pressure or coronary artery disease, can help reduce the strain on the heart and potentially improve murmur-related symptoms.

Living with a Heart Murmur

For individuals with heart murmurs, regular monitoring and follow-up with a cardiologist or cardiovascular medicine specialist are crucial. In many cases, heart murmurs may not cause any significant murmur symptoms or complications, and individuals can lead normal, active lives with proper management and following clinical practice guidelines.

However, it is essential to be aware of potential warning signs that may indicate a worsening condition, such as shortness of breath, chest pain, palpitations, fatigue, sudden weight gain, or swelling in the legs. Promptly reporting any new or concerning symptoms to a healthcare provider is crucial for timely intervention, treatment adjustments, and prevention of complications like heart valve disease or rheumatic heart disease.

Additionally, individuals with heart murmurs should be mindful of their family history of heart disease, as some conditions may have a genetic component. Maintaining a healthy lifestyle, adhering to treatment plans, and regular checkups can help manage heart murmurs effectively and reduce the risk of future complications.


Heart murmurs or abnormal heart sounds are audible indicators of potential underlying cardiovascular disease, heart defects, or valvular heart disease, ranging from harmless innocent murmurs to potentially serious pathological murmurs. While some innocent murmurs or murmur venous hum may be harmless and require no treatment, others may signal the need for prompt medical attention and management of conditions like congenital heart defects, rheumatic heart disease, or aortic stenosis.

By understanding the causes, diagnosis, and treatment options for heart murmurs, individuals can take an active role in their cardiovascular health. Regular checkups with a cardiologist or cardiovascular medicine specialist, adherence to prescribed treatments like medications (e.g., blood thinners), surgical interventions (e.g., open heart surgery for valve repair/replacement), and a heart-healthy lifestyle can help manage heart murmurs and reduce the risk of potential complications such as heart failure, blood clots, or stroke.

Remember, the murmuring in heart may be a subtle whisper, abnormal heart sounds like systolic murmurs, diastolic murmurs, or continuous murmurs, but listening to it and seeking medical guidance can be the key to maintaining a strong and healthy cardiovascular system. Early detection and management of significant murmurs, whether caused by conditions like mitral valve prolapse, aortic regurgitation, or septal defects, can help prevent further progression and complications.

Factors like family history of heart disease, high blood pressure, coronary artery disease, and lifestyle choices can influence the risk and progression of heart murmurs. By being proactive, following clinical practice guidelines, managing conditions like hypertension or an overactive thyroid gland, and working closely with healthcare professionals, individuals can better navigate the complexities of heart murmurs and prioritize their overall cardiac health.

At Avicenna Cardiology, we believe in fostering a trusting relationship with every patient. Our founder, Dr. Azadeh Beheshtian, is a highly accomplished interventional cardiologist with a passion for women’s heart health. With her extensive training and personalized approach, she develops thoughtful care plans tailored to maximize your health outcomes.

Frequently Asked Questions

Innocent murmurs, also known as innocent heart murmurs or murmur venous hum, can be caused by factors like increased blood flow during pregnancy, anemia, or an overactive thyroid gland. These murmurs are generally harmless and may resolve on their own.

Symptoms that may indicate a more serious heart murmur include shortness of breath, chest pain, fatigue, heart murmur symptoms like a loud murmur heard, sudden weight gain, or swelling in the legs. Consult a doctor if you experience these signs.

Diagnosis typically begins with a physical examination, where a doctor listens for abnormal heart sounds or a rasping sound heard using a stethoscope. Additional tests like echocardiograms, electrocardiograms (EKG/ECG), chest X-rays, or cardiac catheterization may be recommended to identify the underlying cause.

Pathological murmurs can be caused by conditions like valvular heart disease (e.g., aortic stenosis, mitral valve prolapse), congenital heart defects (e.g., atrial septal defect, ventricular septal defect), or cardiovascular diseases like high blood pressure or coronary artery disease.

Treatment depends on the underlying cause and severity. Options may include medication (e.g., blood thinners, diuretics), surgical intervention (e.g., open heart surgery for valve repair/replacement), or lifestyle modifications like managing high blood pressure or heart disease risk factors.

Yes, family history can influence the risk of developing certain types of heart murmurs or heart defects. Individuals with a family history of heart valve disease, congenital heart defects, or conditions like rheumatic fever should be closely monitored.

Systolic murmurs occur during the contraction phase (systole) of the heart muscle when blood is pumped out, while diastolic murmurs occur during the relaxation phase (diastole) when the heart chambers fill with blood.

No, not all heart murmurs are serious. Innocent murmurs or called innocent murmurs are common and harmless, often occurring in children and pregnant women. However, abnormal murmurs or significant murmurs may indicate an underlying condition that requires medical attention.

Factors like high blood pressure, coronary artery disease, obesity, smoking, and a sedentary lifestyle can contribute to the development or progression of heart murmurs and other cardiovascular diseases. Following clinical practice guidelines and maintaining a heart-healthy lifestyle can help manage murmurs and reduce risk.

About the Author

Azadeh Beheshtian

Azadeh Beheshtian is board certified in cardiovascular disease and internal medicine by the American Board of Internal Medicine. She specializes in interventional cardiology and peripheral artery disease, with a focus on women’s heart health.