Heart murmurs
Background
Heart sounds are noises that are generated by the heart as the heart valves snap shut during different parts of the heat-beat. The noise is created by the conversion of mechanical energy into sound energy and is best heard with a stethascope. In healthy individuals, there are two normal heart sounds, often described as a lub and a dub, that occur in sequence with each heart-beat.
Murmurs in babies or children
Murmurs are generated by turbulent flow of blood & may be
a) physiological (innocent) or
b) pathological (abnormal - due to a structural problem)
Innocent murmurs
Or functional murmurs) are very common in a baby or child and are not due to congenital heart disease. These murmurs are usually generated as a consequence of the blood flowing at speed around tight corners and bends in a relatively smaller heart (as compared to an adult). Innocent murmurs become more apparent during times when the heart works a little harder (producing more turbulence) such as during fever or exertion.
Presentation
Patients are often referred to a Paediatric Cardiologist (baby heart doctor) for assessment following the finding of a heart murmur in a baby or child.
Many clinicians feel uncomfortable about classifying a murmur as ‘innocent’ until formal paediatric cardiac review as they are concerned that an underlying cardiac problem may be missed.
An experienced Paediatric Cardiologist such as Dr Sridharan can often distinguish an innocent from an abnormal murmur just by listening for specific acoustic characteristics.
Investigations
Formal paediatric cardiac assessment will include top to toe clincal examination & a detailed echocardiogram (heart scan) to best assess the structure and function of the heart. The confirmation of normal cardiac structure and function in the context of a murmur is the gold standard for confirming that a murmur is ‘innocent’ in nature.
Treatment
No treatment is required as the heart is normal. Reassurance is given to the child and family. Medical follow-up is not required.An Innocent murmur tends to disappear through childhood and adolescence.