A heart murmur is an unusual sound heard during heartbeats. It is often described as a whooshing, blowing, or rasping noise caused by turbulent blood flow through the heart valves.
While many heart murmurs are harmless (innocent), others can indicate underlying heart conditions that require medical attention.
If you’ve been diagnosed with a heart murmur, being aware of potential symptoms such as shortness of breath, extreme fatigue, chest pain, or difficulty exercising can help you seek timely medical intervention.
Adults with heart murmurs may experience varying symptoms depending on the cause and severity of their condition.
Some people live with heart murmurs without experiencing any symptoms at all, while others might notice declining exercise tolerance, swelling in the extremities, or even fainting episodes.
Recognizing these warning signs is crucial for maintaining cardiovascular health, particularly if you have risk factors for heart valve problems.
Key Takeaways
- Heart murmurs can be innocent or indicate heart valve problems, with symptoms including shortness of breath, fatigue, and chest pain.
- Many adults with heart murmurs experience no symptoms, but monitoring for changes in exercise tolerance or unexplained fatigue is important.
- Regular cardiac checkups are crucial if you have a heart murmur, as early detection and treatment of valve-related issues can significantly improve outcomes.
Understanding Heart Murmurs in Adults
Heart murmurs are unusual sounds detected during a heartbeat, often described as whooshing or swishing noises. These sounds occur when blood flows turbulently through your heart valves or chambers.
While some murmurs are harmless, others may signal underlying heart conditions that require attention.
What Causes Heart Murmurs
Heart murmurs in adults typically develop from structural changes to the heart valves. Valve stenosis occurs when valves narrow and restrict blood flow, while valve regurgitation happens when valves don’t close properly, allowing blood to leak backward. These conditions often result from age-related wear and tear, as well as infections such as endocarditis or rheumatic fever.
Mitral valve prolapse, where valve leaflets bulge back into the atrium, is another common cause. High blood pressure, pregnancy, and hyperthyroidism can create conditions that lead to murmurs without valve damage. Some congenital heart defects may not be discovered until adulthood.
Calcification of heart valves, particularly the aortic valve, becomes more common with age and can lead to murmurs that progress over time.
Types of Heart Murmurs
Heart murmurs are classified into two types: innocent (physiological) and abnormal (pathological).
Innocent heart murmurs don’t indicate heart disease and don’t require treatment. They’re common in children but can occur in adults during pregnancy, exercise, or fever.
Abnormal heart murmurs signal underlying heart problems that may need medical intervention. These murmurs are classified by:
- Timing: Systolic (during heart contraction) or diastolic (during heart relaxation)
- Intensity: Graded on a scale of 1-6, with 6 being the loudest
- Location: Where on the chest the murmur is best heard
Murmurs from mitral regurgitation, aortic stenosis, or mitral stenosis each have distinctive characteristics that help cardiologists identify the specific heart valve problem causing the abnormal sound.
How Heart Murmurs Affect Blood Flow
Heart murmurs directly reflect disruptions in your heart’s blood flow patterns.
In a healthy heart, blood moves smoothly through chambers and valves with minimal turbulence. When valve problems develop, they create a turbulent flow that produces the characteristic murmur sound.
With stenosis, blood must force through a narrowed opening, creating a high-velocity jet stream that causes vibrations. This restricts forward flow, potentially reducing the amount of oxygenated blood reaching your body’s tissues.
In regurgitation, blood flows backward through leaky valves, creating inefficient circulation patterns. Your heart must work harder to maintain adequate forward blood flow, which can lead to heart enlargement over time.
Innocent murmurs don’t significantly alter blood flow dynamics. However, pathological murmurs can progressively impact your heart’s pumping efficiency, potentially leading to fatigue and shortness of breath as your heart struggles to meet your body’s oxygen demands.
Key Heart Murmur Symptoms in Adults
Adults with abnormal heart murmurs may experience several concerning symptoms that indicate underlying heart valve problems or diseases. These symptoms often develop gradually and may worsen when engaging in physical activity or upon lying down.
Shortness of Breath
Shortness of breath (dyspnea) is among the most common symptoms of problematic heart murmurs in adults. You may notice difficulty breathing during activities that previously caused no issues, such as climbing stairs or walking short distances.
This breathing difficulty often worsens when lying flat, causing you to prop yourself up with extra pillows at night. This condition, called orthopnea, occurs because blood flow changes in the reclined position.
Some adults experience paroxysmal nocturnal dyspnea—a frightening symptom where you wake up suddenly gasping for air. This occurs when fluid accumulates in the lungs due to the heart’s inefficiency in pumping blood, a potential consequence of valve problems that cause the murmur.
Fatigue and Weakness
Unusual fatigue and persistent weakness often signal that your heart isn’t working efficiently due to valve problems, which can cause a murmur. You might feel exhausted after minimal exertion or even when resting.
This fatigue occurs because your heart struggles to pump enough oxygenated blood to meet your body’s needs. Your muscles and organs receive less oxygen, resulting in a persistent feeling of fatigue that persists despite rest.
You may also notice a decrease in exercise tolerance, and activities that you once handled easily now leave you feeling drained. This progressive limitation in physical capacity often develops gradually, making it easy to attribute to age or being out of shape rather than a heart condition.
Chest Pain or Discomfort
Chest pain or discomfort associated with heart murmurs can manifest in several ways.
You might experience a squeezing sensation, pressure, or burning in your chest, particularly during physical activity. Some people describe a fluttering feeling (palpitations) when valve problems cause irregular heartbeats.
These sensations may radiate to your neck, jaw, back, or arms. Unlike the crushing pain of a heart attack, murmur-related discomfort often comes and goes, sometimes triggered by exertion and relieved by rest. However, any chest pain warrants immediate medical attention to rule out serious conditions.
Swelling and Lightheadedness
Fluid retention, causing swelling (edema) in your ankles, feet, legs, or abdomen, can indicate your heart isn’t pumping efficiently due to valve problems.
This swelling typically worsens throughout the day and improves overnight when your legs are elevated. Lightheadedness or dizziness occurs when your brain doesn’t receive adequate blood flow.
You might feel faint when standing up quickly or during exertion. In severe cases, valve disorders can cause fainting (syncope), especially during physical activity.
This occurs when your heart can’t increase its output to meet the demands of exercise. Despite no changes in diet or activity level, weight gain may also occur due to fluid retention. You may notice that your shoes feel tighter or that rings become difficult to remove due to this fluid accumulation.
Common Causes and Risk Factors
Heart murmurs develop due to various underlying conditions that affect blood flow through the heart. Understanding these causes can help you identify your risk level and take appropriate preventive measures.
Aging and Degenerative Changes
As you age, your heart valves may undergo natural degenerative changes. Calcification—the buildup of calcium deposits on valve tissues—commonly affects the aortic valve in adults over 65.
This process stiffens the valve, restricting normal blood flow. Age-related valve thickening can progress gradually, often without symptoms, until the condition becomes more severe.
Regular cardiac check-ups become increasingly important as you enter middle age. Heart valve degeneration may accelerate if you have high blood pressure, high cholesterol, or diabetes.
These conditions can damage valve tissue and contribute to abnormal blood flow patterns. Mitral valve prolapse, where valve leaflets bulge backward, becomes more problematic with age as supporting structures weaken. This condition affects approximately 2% of the adult population.
Congenital Heart Defects
Some heart murmurs stem from structural abnormalities present since birth.
The bicuspid aortic valve, characterized by a valve with two leaflets instead of three, is the most common congenital heart defect in adults, affecting approximately 1-2% of the population.
Septal defects, openings between heart chambers, may go undetected until adulthood.
Atrial septal defects (ASD) and ventricular septal defects (VSDs) cause distinctive murmurs as blood flows abnormally between chambers.
Patent ductus arteriosus (PDA), a condition where a fetal blood vessel fails to close after birth, can cause continuous murmurs.
Though often diagnosed in childhood, milder cases may first present in adulthood. These congenital conditions vary in severity. Some require surgical intervention, while others might only need monitoring and lifestyle modifications.
Infections and Endocarditis
Infective endocarditis, an infection of the heart’s inner lining, can develop when bacteria enter your bloodstream and attach to damaged heart valves. This serious condition often produces new or changed heart murmurs.
Risk factors include previous valve damage, the presence of artificial heart valves, or certain congenital heart defects. Intravenous drug use and poor dental hygiene also increase your risk substantially.
Rheumatic fever, though less common in developed countries, remains a significant cause of heart valve damage worldwide. This inflammatory disease typically follows untreated strep throat infections and can lead to rheumatic heart disease.
Symptoms of endocarditis include fever, fatigue, and heart murmurs. Prompt treatment with antibiotics is essential to prevent permanent valve damage.
Underlying Heart Diseases
Cardiomyopathy, a heart muscle disease, can cause the heart chambers to enlarge and disrupt normal blood flow patterns. This often creates conditions for murmurs to develop.
Heart valve diseases, such as stenosis (narrowing) and regurgitation (leaking), directly cause murmurs. Aortic stenosis, which is more common in older adults, produces a characteristic systolic murmur that healthcare providers can easily detect.
Mitral regurgitation allows blood to flow backward from the left ventricle to the left atrium, creating turbulent flow and a distinctive murmur. This condition can result from valve prolapse, damaged heart tissue, or complications from heart attacks.
Hypertrophic cardiomyopathy, an abnormal thickening of the heart muscle, obstructs blood flow and produces murmurs that change in volume and pitch with changes in position and activity level.
Diagnosis and Next Steps
If you’ve discovered a heart murmur during a routine check-up, understanding the diagnostic process and treatment options can help ease concerns. A proper evaluation by healthcare professionals will determine whether your heart murmur requires intervention or simply monitoring.
When to See a Cardiologist
You should consult a cardiologist if your primary care physician detects a heart murmur during a physical examination. This is especially important if you experience shortness of breath, unexplained fatigue, bluish discoloration of fingertips or lips, or sudden weight gain. Don’t delay seeking medical attention if you have chest pain along with a heart murmur, as this combination requires prompt evaluation.
A cardiologist specializes in heart conditions and can determine whether your murmur is innocent (harmless) or indicates an underlying heart issue. Even if your murmur seems harmless, regular follow-ups with your cardiologist help ensure that any changes are detected early. Some initially benign murmurs can develop into more serious conditions over time.
Common Diagnostic Tests
Several tests help determine the cause and severity of a heart murmur. An electrocardiogram (ECG or EKG) records your heart’s electrical activity and can help identify irregular rhythms or structural issues that may be causing the murmur.
The doctor may order blood tests to check for infection, anemia, or thyroid problems that could contribute to heart murmurs. They might also recommend a stress test to evaluate your heart’s performance during physical activity.
A chest X-ray provides images of the heart and lungs, enabling doctors to identify enlarged hearts or fluid accumulation in the lungs. This test can provide valuable insights into potential valve problems, such as mitral valve prolapse or aortic valve stenosis.
In some cases, cardiac catheterization might be recommended to measure pressure within the heart chambers and assess valve function more directly.
Echocardiogram and Imaging
An echocardiogram is the gold standard for diagnosing the cause of heart murmurs. This noninvasive ultrasound test creates detailed images of the heart’s structure and function, including blood flow patterns through the valves.
During this procedure, a technician uses a wand-like device called a transducer to capture images of your heart. The test can identify abnormalities such as valve prolapse, pulmonary valve stenosis, or holes in the heart’s chambers.
There are several types of echocardiograms:
- Transthoracic echocardiogram (TTE): The standard approach, performed externally on your chest
- Transesophageal echocardiogram (TEE): Provides clearer images using a probe inserted down your throat
- Doppler echocardiogram: Specifically measures blood flow through your heart valves
Your doctor might also recommend a 3D echocardiogram for more detailed imaging of complex heart structures and valve issues.
Managing and Monitoring Heart Murmurs
Treatment for heart murmurs depends entirely on the underlying cause. Innocent murmurs typically require no treatment, only regular monitoring during checkups.
If your murmur stems from valve problems, such as mitral valve prolapse or aortic stenosis, your cardiologist will develop a management plan. This may include medications to reduce symptoms, prevent complications, or address underlying conditions that contribute to the murmur.
Adopting a heart-healthy lifestyle is important, regardless of the severity of your murmur. This includes:
- Regular, appropriate exercise (with your doctor’s guidance)
- A balanced diet low in sodium and saturated fats
- Maintaining a healthy weight
- Avoiding tobacco products
- Managing stress effectively
In some cases, surgical intervention, valve repair, or valve replacement may be necessary for severe valve disorders. Your cardiologist will discuss the benefits and risks of each treatment option, tailored to your specific condition.
Frequently Asked Questions
What are the common symptoms indicating a heart murmur in adults?
Common symptoms of heart murmurs in adults include shortness of breath, especially during physical activity or while lying down. You may experience chest pain, dizziness, or sudden fainting spells.
Some adults report feeling their heart racing or fluttering (palpitations). Excessive fatigue that persists despite rest can signal a potentially problematic heart murmur.
Swelling in the legs, ankles, or abdomen might occur due to fluid retention associated with certain heart valve problems. In severe cases, some patients may notice a bluish discoloration of their skin (cyanosis).
Are there specific lifestyle changes recommended for adults who have been diagnosed with a heart murmur?
Many adults with heart murmurs benefit from maintaining a heart-healthy diet low in sodium and saturated fats. Regular, moderate exercise, as recommended by your cardiologist, can strengthen your cardiovascular system without overexertion.
Weight management is crucial, as excess weight puts a strain on your heart. You should avoid smoking and limit alcohol consumption to reduce stress on your cardiovascular system.
Stress management techniques, such as meditation, deep breathing, or yoga, may help alleviate symptoms. Getting sufficient sleep and staying hydrated also support overall heart health.
How does a heart murmur impact overall cardiovascular health in adults?
Innocent heart murmurs typically don’t affect cardiovascular health. However, abnormal heart murmurs may indicate underlying valve problems that, if left untreated, can lead to heart failure.
Some heart murmurs can cause your heart to work harder to pump blood, potentially leading to enlargement of the heart muscle. This additional strain might increase your risk of developing arrhythmias or other cardiac complications.
Valve-related murmurs may worsen, affecting your heart’s efficiency and overall function. Regular monitoring by a cardiologist helps track any changes in your condition.
When should an adult seek medical attention for a suspected heart murmur?
Seek immediate medical attention if you experience severe shortness of breath, chest pain, or fainting. These symptoms may indicate a serious heart condition that requires prompt evaluation.
Consult a doctor if you experience increasing fatigue, decreased exercise tolerance, or swelling in your extremities. Persistent heart palpitations or a racing heartbeat that occurs frequently warrant medical evaluation.
Regular check-ups are important even for previously diagnosed “innocent” murmurs, as they can sometimes change over time. If you have a family history of heart valve disease, more vigilant monitoring may be recommended.
What diagnostic tests can a cardiologist perform to evaluate a heart murmur in adults?
Echocardiograms utilize sound waves to produce detailed images of the heart’s structure and function. This non-invasive test helps identify valve abnormalities and blood flow patterns.
Electrocardiograms (ECGs) record your heart’s electrical activity and can detect irregular heartbeats or signs of heart enlargement. Chest X-rays may be ordered to assess for heart enlargement or the presence of lung fluid.
Advanced testing might include cardiac MRI for detailed heart imaging or cardiac catheterization to measure pressures within heart chambers. Stress tests can evaluate how your heart functions during physical exertion.
Is it possible for stress or anxiety to initiate or worsen heart murmur symptoms?
Stress and anxiety can increase heart rate and blood pressure. This may make existing murmurs more pronounced.
Your cardiovascular system works harder when under stress. This can temporarily intensify symptoms.
Anxiety can sometimes mimic or exacerbate symptoms like palpitations, chest discomfort, and shortness of breath. These psychological factors don’t cause structural heart problems but may affect how you perceive symptoms.
Recognizing the symptoms of a heart murmur in adulthood can make a critical difference in your long-term health. While many murmurs are harmless, others may be early indicators of more serious heart valve conditions. By paying attention to changes in your breathing, energy levels, or any unusual chest sensations, you can take the right steps to protect your heart. Early diagnosis and regular follow-up care with a specialist remain the most effective ways to prevent and manage potential complications.
If you’ve noticed symptoms or been told you have a heart murmur, schedule a comprehensive heart evaluation with the experts at Cardiovascular Group. Our board-certified cardiologists are here to help you understand your condition and guide you through every step of your care.
