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A heart murmur is an abnormal heart sound that results from the turbulent flow of blood through the heart. Heart murmurs are usually detected by a physician listening to the heartbeat with a stethoscope. Although many heart murmurs are unassociated with disease, they may also stem from a cardiovascular problem such as:
- Valvular stenosis. A narrowing of one of the heart’s four valves which causes blood flow to become more turbulent as it is forcefully pumped through the smaller opening. The character of the murmur can give the physician clues about which valve(s) is/are affected.
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- Mitral valve prolapse. A condition in which the flaps of the mitral valve (located between the left atrium and left ventricle) cannot close properly. As a result, blood may leak back through the valve (mitral regurgitation), when it should only move forward.
- Aortic regurgitation. A condition in which the aortic valve (located between the left ventricle and the aorta) does not close properly, allowing blood to leak back into the left ventricle rather than being pumped out to the body.
- Tricuspid regurgitation. A condition in which the tricuspid valve (located between the right atrium and right ventricle) does not close properly, allowing some blood to leak backward from the right ventricle into the right atrium during contraction
- Aortic aneurysm. The dilation, bulging or ballooning out of part of the wall of the aorta, resulting in a murmur caused by aortic regurgitation. Untreated, aortic aneurysm puts the patient at risk for a ruptured aneurysm.
- Congenital heart disease. Heart defects or other conditions present since birth. This is the most common cause of non-innocent heart murmurs. Heart murmurs can be caused by septal defects, as well as shunts that allow the blood to travel from one side of the heart to the other inappropriately.
- Enlarged heart. An increase in the size of the heart muscle that indicates that the heart is overworked. An enlarged heart due to a non-cancerous tumor called a cardiac myxoma may cause a heart murmur. Heart murmurs may also be caused by hypertrophic cardiomyopathy, a condition in which the heart becomes enlarged and weakened.
- Increased transvalvular blood. A condition in which blood is flowing more rapidly than normal through the heart’s lower chambers (ventricles).
Innocent murmurs (sometimes called Still’s or functional heart murmurs) do not represent any long-term heart-related problems and are not related to any structural abnormality of the heart. They are associated with rapid or unusual blood flow through the heart's valves. Such situations are associated with overactive thyroid function, fever, anemia and pregnancy.
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