Heart Murmurs: Risk Factors for Heart Attack

Key Takeaways

Most heart murmurs are innocent and do not increase your risk of heart attack or other serious problems.
Abnormal murmurs may signal valve disease or structural heart problems that require medical monitoring and treatment.
Regular checkups and proper management of underlying conditions can help reduce any cardiovascular risks associated with problematic murmurs.

What Is a Heart Murmur?

A heart murmur is an extra sound we hear between the normal heartbeats when blood flows turbulently through the heart. Heart murmurs range from harmless innocent sounds to signs of serious heart problems that need medical attention.

Understanding the Sounds of the Heart

When we listen to a healthy heart, we hear two main sounds called “lub-dub.” The first sound happens when valves between the heart’s upper and lower chambers close.

The second sound occurs when valves leading to major blood vessels close. A heart murmur creates a whooshing or swishing noise between these normal sounds.

This extra sound comes from turbulent blood flow through the heart’s chambers or valves.

Normal heart sounds:

Lub – valves close as heart squeezes blood out
Dub – valves close as heart fills with blood

Heart murmurs can happen at different times during the heartbeat cycle. We can hear them through a stethoscope during routine checkups.

The location and timing of the murmur helps doctors understand what might be causing it. Some murmurs are very soft while others are loud enough to feel as vibrations on the chest.

Types of Heart Murmurs

Heart murmurs are grouped by when they happen during the heartbeat cycle. Each type gives doctors important clues about what’s causing the extra sound.

Systolic murmurs occur when the heart contracts and pushes blood out to the body. These are the most common type of heart murmur.

Many systolic murmurs are innocent and don’t signal heart problems. Diastolic murmurs happen when the heart relaxes and fills with blood.

These murmurs are less common but more likely to indicate heart valve problems that need treatment. Continuous murmurs last throughout the entire heartbeat cycle.

They occur during both the squeezing and filling phases of the heart. Doctors also grade murmurs on a scale from 1 to 6 based on how loud they are.

Grade 1 murmurs are very soft. Grade 6 murmurs are so loud they can be heard without a stethoscope touching the chest.

Innocent vs Abnormal Heart Murmurs

Innocent heart murmurs are harmless sounds that don’t indicate heart disease. These benign murmurs are very common in children and often disappear as they grow older.

Innocent heart murmurs:

Create soft, gentle sounds
Don’t cause symptoms
Often found in healthy children
May appear during fever or exercise
Require no treatment

Abnormal heart murmurs signal underlying heart problems that need medical attention. These murmurs often sound louder and harsher than innocent ones.

Abnormal heart murmurs can result from heart valve problems, holes in the heart’s walls, or other structural defects. They may cause symptoms like shortness of breath, chest pain, or unusual tiredness.

Some abnormal heart murmurs are present from birth due to congenital heart defects. Others develop later in life from conditions like valve disease or heart infections.

We can only determine if a heart murmur is innocent or abnormal through proper medical evaluation and testing.

Heart Murmurs and Risk of Heart Attack

Heart murmurs do not directly cause heart attacks, but abnormal murmurs can signal underlying cardiovascular conditions that may increase heart attack risk. Understanding this connection helps us assess when heart murmurs require closer monitoring and treatment.

Can Heart Murmurs Lead to Heart Attacks?

Heart murmurs themselves cannot cause heart attacks. A heart attack happens when blood flow to part of the heart gets blocked by a clot in a narrowed artery.

Most heart murmurs are innocent and pose no health risks. These harmless murmurs are common in children and often disappear with age.

Abnormal heart murmurs work differently. They don’t cause heart attacks but may indicate heart conditions that could increase cardiovascular risk over time.

The key difference lies in what causes the murmur. Innocent murmurs come from normal blood flow through a healthy heart.

Abnormal murmurs suggest structural problems that need evaluation. We find that patients with abnormal murmurs benefit from regular heart monitoring.

This helps us catch any developing cardiovascular issues early.

Heart Murmurs as Markers of Cardiovascular Health

Heart murmurs serve as important indicators of overall cardiovascular health. When we detect an abnormal murmur, it alerts us to examine the heart more closely.

Innocent murmurs typically indicate good heart health. They often occur during:

Fever or illness
Physical activity
Pregnancy
Growth spurts in children

Abnormal murmurs may signal cardiovascular issues that require attention. These sounds help us identify problems before symptoms appear.

We use murmurs as part of a complete heart assessment. They guide our decisions about additional testing like echocardiograms or stress tests.

Regular check-ups allow us to track changes in murmur characteristics. New murmurs or changes in existing ones may indicate developing heart conditions.

Underlying Conditions Linking Murmurs and Heart Attack Risk

Several heart conditions that cause abnormal murmurs can increase cardiovascular risk. These conditions don’t directly cause heart attacks but may contribute to heart problems over time.

Valve problems are common causes of abnormal murmurs. Damaged or diseased valves can:

Force the heart to work harder
Lead to irregular heart rhythms
Cause blood flow problems

Congenital heart defects present from birth may create murmurs and affect long-term heart health. These structural problems can strain the cardiovascular system.

Cardiomyopathy affects heart muscle function and often produces murmurs. This condition can lead to heart failure if left untreated.

We also see murmurs with conditions like high blood pressure and coronary artery disease. These cardiovascular issues directly increase heart attack risk and require ongoing management.

Causes of Heart Murmurs

Heart murmurs develop when blood flows turbulently through the heart or its valves. The most common causes include valve problems like stenosis and regurgitation, structural heart defects present from birth, and various health conditions that affect blood flow.

Valve Problems and Stenosis

Heart valve disorders create the most common causes of abnormal heart murmurs in adults. Stenosis occurs when heart valves become narrow and restrict blood flow.

This narrowing forces blood to squeeze through smaller openings, creating turbulent flow we hear as murmurs. Aortic valve stenosis is particularly common as people age.

Calcium deposits build up on valve leaflets over time. This makes valves stiff and unable to open fully.

Regurgitation happens when valves don’t close properly. Blood leaks backward through these faulty valves.

This creates distinctive whooshing sounds during different parts of the heartbeat cycle. Age-related wear affects valve function gradually.

Infections can also damage valve tissue permanently. Bicuspid aortic valve is a birth defect where the aortic valve has two leaflets instead of three, making it more prone to problems.

Congenital Heart Defects

Congenital heart defects cause many heart murmurs detected in children. These structural problems exist from birth and affect normal blood flow patterns through the heart.

Septal defects create “holes in the heart” between chambers. Blood flows through these openings when it shouldn’t.

Atrial septal defects occur between the upper chambers. Ventricular septal defects happen between the lower chambers.

Patent ductus arteriosus occurs when a blood vessel fails to close after birth. This creates abnormal blood flow between major arteries.

The condition produces continuous murmurs throughout the heartbeat cycle. Coarctation of the aorta involves narrowing of the main artery leaving the heart.

This forces blood through a smaller space and creates characteristic murmurs.

Other Contributing Factors

Several health conditions can trigger heart murmurs by changing blood flow or heart function. High blood pressure makes the heart work harder and can cause functional murmurs over time.

Hyperthyroidism speeds up heart rate and increases blood flow. This creates temporary murmurs that often resolve when thyroid levels return to normal.

Fever and anemia also increase blood flow velocity. Cardiomyopathy affects heart muscle function directly.

Hypertrophic cardiomyopathy thickens heart walls and can obstruct blood flow. This genetic condition often causes murmurs that change with position or activity level.

Pregnancy increases blood volume significantly. Many pregnant women develop innocent murmurs that disappear after delivery.

These pose no health risks to mother or baby.

Symptoms and Warning Signs

Heart murmur symptoms can range from barely noticeable to severely limiting daily activities. Many adults with innocent murmurs experience no symptoms at all, while abnormal murmurs often produce specific warning signs that require immediate medical evaluation.

Recognizing Common Symptoms

Shortness of breath is one of the most frequent symptoms we see in patients with abnormal heart murmurs. You may notice difficulty breathing during activities that never caused problems before, like walking up stairs or doing light housework.

This breathing trouble often gets worse when lying flat. Many patients tell us they need extra pillows at night to sleep comfortably.

Chest pain can feel like pressure, squeezing, or a burning sensation in your chest. The pain may spread to your neck, jaw, or arms.

Unlike heart attack pain, murmur-related chest discomfort usually comes and goes. Fatigue and weakness happen when your heart struggles to pump enough blood to meet your body’s needs.

You might feel exhausted after minimal activity or even while resting. Other common symptoms include:

Palpitations or fluttering sensations in your chest
Dizziness or lightheadedness, especially when standing quickly
Swelling in your ankles, feet, or legs that worsens during the day
Weight gain from fluid buildup
Cyanosis – a bluish color in your fingernails or lips

When to Seek Medical Attention

Seek emergency care immediately if you experience chest pain combined with shortness of breath, especially during physical activity. Any chest pain warrants prompt medical evaluation to rule out serious heart conditions.

Call your doctor right away if you notice sudden weight gain of more than 2-3 pounds in a day or 5 pounds in a week. This rapid weight increase often signals fluid retention from heart problems.

Fainting episodes during exercise or physical activity require urgent medical attention. This can indicate that your heart cannot pump enough blood to meet increased demands.

Contact your healthcare provider if you develop:

New or worsening shortness of breath
Swelling that doesn’t improve with rest and elevation
Persistent fatigue that limits your daily activities
Heart palpitations that last more than a few minutes

Even if your symptoms seem mild, any new or changing symptoms in someone with a known heart murmur should be evaluated by a cardiologist.

Diagnosis and Evaluation

Doctors use a combination of physical examination and specialized tests to diagnose heart murmurs and determine their cause. A cardiologist plays a key role in evaluating abnormal heart sounds and deciding if treatment is needed.

Physical Examination

The first step in diagnosing a heart murmur happens during a routine physical exam. We listen to your heart with a stethoscope to detect unusual sounds between heartbeats.

During the exam, we check for the characteristic whooshing or humming sounds that indicate a murmur. We listen at different points on your chest to determine where the sound is loudest.

Key aspects we evaluate include:

Timing of the murmur (during heart contraction or relaxation)
Loudness level on a scale of 1 to 6
Location where the sound is heard best
Quality of the sound (harsh, blowing, or musical)

We may ask you to change positions or take deep breaths during the exam. These actions can make certain murmurs easier to hear or help us tell the difference between harmless and serious murmurs.

Diagnostic Tests for Heart Murmurs

When we detect a heart murmur, several tests help us determine its cause and severity. An echocardiogram is the most common test we use to evaluate heart murmurs.

A transthoracic echocardiogram uses sound waves to create moving pictures of your heart. This test shows us your heart valves, chambers, and blood flow patterns without any discomfort.

We also use an electrocardiogram (ECG) to record your heart’s electrical activity. While an ECG cannot detect murmurs directly, it reveals conditions that might cause them.

A chest X-ray helps us see your heart’s size and shape. This test can show if your heart chambers are enlarged, which sometimes happens with valve problems.

For some patients, we recommend a stress test to see how the heart murmur changes during physical activity. This helps us understand if the underlying condition affects your heart’s function during exercise.

Role of the Cardiologist

A cardiologist specializes in diagnosing and treating heart conditions, including heart murmurs. We have specialized training to interpret the sounds your heart makes and determine their meaning.

When your primary doctor detects a murmur, they may refer you to us for further evaluation. We use advanced listening techniques and our experience to classify murmurs as innocent or abnormal.

We interpret all test results together to make an accurate diagnosis. This includes combining findings from physical exams, echocardiograms, ECGs, and other tests.

Our evaluation process includes:

Detailed review of your symptoms and medical history
Advanced cardiac testing when needed
Development of treatment plans for abnormal murmurs
Long-term monitoring of heart valve conditions

We also determine if you need ongoing follow-up care or treatment. For innocent murmurs, we provide reassurance that no treatment is needed.

Treatment Approaches and Prognosis

Treatment plans depend on whether the heart murmur is innocent or caused by underlying heart valve diseases. Most innocent murmurs need no treatment, while valve problems may require medications or surgery to prevent heart failure and other complications.

Managing Innocent Heart Murmurs

Innocent heart murmurs require no medical treatment. We simply monitor these murmurs during regular checkups to ensure they remain harmless.

Many innocent murmurs disappear on their own over time. This happens especially in children as they grow older.

If an underlying condition like fever or hyperthyroidism causes the murmur, we treat that condition first. The murmur usually goes away once we address the root cause.

Regular monitoring includes:

Annual physical exams
Listening to heart sounds with a stethoscope
Blood pressure checks
Symptom assessment

We may recommend lifestyle changes to support heart health. These include regular exercise, a balanced diet, and avoiding smoking.

Most people with innocent murmurs live normal, active lives without restrictions.

Treating Underlying Heart Valve Diseases

Heart valve diseases causing murmurs need specific treatment based on the type and severity. We use medications, surgical procedures, or both to manage these conditions.

Medications we prescribe include:

Blood pressure medications to reduce heart strain
Diuretics to prevent fluid buildup
Blood thinners to prevent clots
Antibiotics to prevent endocarditis

Valve repair is often our preferred surgical option when possible. This preserves your natural valve function and typically has better long-term results than replacement.

Valve replacement becomes necessary when repair isn’t possible. We use either mechanical or biological valves depending on your age and health status.

We treat conditions like rheumatic fever that can damage heart valves. Early treatment prevents valve regurgitation and other complications.

For severe valve diseases, we may recommend minimally invasive procedures. These include catheter-based repairs that require shorter recovery times.

Prognosis and Long-Term Outlook

The prognosis for heart murmurs varies greatly depending on the underlying cause. Innocent murmurs have an excellent outlook with no impact on life expectancy.

People with treated heart valve problems often live normal lifespans. Early detection and proper treatment prevent progression to heart failure in most cases.

Factors affecting prognosis:

Type of valve disease
Severity at diagnosis
Response to treatment
Overall heart function

We monitor patients with valve diseases through regular echocardiograms and cardiac evaluations. This helps us detect changes early and adjust treatment as needed.

Untreated severe valve diseases can lead to heart failure, stroke, or sudden cardiac death. With proper medical care, we can prevent these serious complications.

Most patients return to normal activities after valve repair or replacement surgery. Recovery typically takes 6-12 weeks depending on the procedure type.

We work closely with patients to manage risk factors and maintain heart health long-term. This includes controlling blood pressure, managing cholesterol, and preventing infections that could affect heart valves.

Conclusion: Stay Informed, Stay Heart-Healthy

While most heart murmurs are harmless, some may signal deeper cardiovascular issues that require expert evaluation. Understanding the type and cause of a murmur is the first step in protecting your heart health. Whether you’re experiencing symptoms or simply want peace of mind, timely checkups and ongoing monitoring can make all the difference.

Concerned about a heart murmur or your risk for heart disease? Book an appointment with CVG today to speak with one of our experienced cardiologists. Your heart deserves expert care.