The human heartbeat is usually steady: lub-dub, lub-dub. In some people, though, the blood makes an extra noise as it flows through the heart. This sound is called a murmur

A heart murmur is indeed one of the most common reasons for children to be referred to a pediatrician or pediatric cardiologist. It is important to understand that a heart murmur is not a diagnosis in itself but rather an abnormal sound that can be heard during a physical examination of the heart. Let me explain further.

When a doctor or nurse listens to the heart using a stethoscope, they can hear different sounds produced by the heart's valves and blood flow. A normal heart usually produces a steady "lub-dub" sound, which corresponds to the closing of the heart valves. However, in some cases, an additional sound, known as a heart murmur, can be heard. This murmur can range from a gentle swishing sound to a more noticeable whooshing or blowing sound.

While it is true that heart murmurs can sometimes be associated with underlying heart conditions, such as congenital heart defects or valve abnormalities, the presence of a heart murmur alone does not necessarily indicate a serious problem. In fact, many heart murmurs in children are innocent or harmless, meaning they don't pose any health risks and often resolve on their own as the child grows.

To determine the cause and significance of a heart murmur, further evaluation is usually required. This may involve additional tests, such as an echocardiogram (ultrasound of the heart), which provides detailed images of the heart's structure and function. Based on these findings, a pediatric cardiologist can make a more accurate diagnosis and recommend appropriate management or treatment if necessary.

It's important to dispel the misconceptions surrounding heart murmurs, as they can lead to unnecessary anxiety or misunderstanding. If a child is found to have a heart murmur, it's best to consult a medical professional who can provide a thorough evaluation and proper guidance based on the individual case.

Most children can have a heart murmur heard at some point in their lives. And there’s lots of reasons for this. Their chest walls are thin, blood is moving quickly, the structures are a bit smaller, so it’s very common to hear this normal blood flow sound. In fact, most heart murmurs are just that; they’re just the sound of normal blood flow in otherwise healthy children.

A heart murmur in and of itself doesn’t really have symptoms. A heart murmur rarely means there’s underlying heart disease. And that heart disease may be associated with symptoms. Particularly in young children, in infants, difficulties with feeding, or growing, breathing difficulties, those can be signs of heart disease. And sometimes that heart disease presents with a heart murmur—the sound of the abnormal blood flow in this case. Again, it’s important to remember that most heart murmurs represent normal blood flow in otherwise healthy children.

A heart murmur will often be picked up as an incidental finding. A child may be at a routine health appointment. A common scenario is during another illness, so a viral illness—particularly one that is associated with a fever—a murmur might be heard at that time. Once a heart murmur is heard, it’s common to be referred to a pediatrician or a pediatric cardiologist, who may in turn order additional investigations.

Since most children with heart murmurs don’t have any heart disease at all, there may not be a need for any testing. If the heart murmur is found to be associated with heart disease, there may be treatment required. Many forms of heart disease don’t require any treatment at all. These will be the things that you discuss with your pediatric cardiologist. If you do have any questions about heart murmurs, your family doctor or your pediatrician will be happy to talk to you.

NOW Health Network Local Practitioners: Cardiologist