EVALUATING A HEART MURMUR IN ADULTS:
When blood flows normally through the heart valves, it makes a two beat "lub-lub" sound.
With a murmur , the blood is not flowing normally through the heart valves. Physicians may hear through a stethoscope any of a variety of " Swishing" sounds that can differ in volume, pitch and duration.
Where does the murmur reach its peak of intensity? This information helps in guiding a cardiologist as to whether the murmur is incorrect or of more concern. In a crescendo murmur for example, the sound whooshes up and then suddenly stops. So just from the way it sounds, you can often draw conclusions as to the type and seriousness of the murmur.
Murmur can be caused by a heart valve abnormality or a defect in the muscular structure of the heart. In a few cases, it can be present from birth because of an anatomical malformation. Murmurs detected in children can be innocent or related to congenital heart defect, and should be referred to a pediatric cardiologist.
Differentiating whether a heart murmur is innocent or requires follow up by a cardiologist depends on the symptoms , the timing, characteristics of the murmur and the general condition of the patient.
Types of heart murmurs-
Heart murmurs generally classified into 2 categories: innocent and abnormal.
1) Innocent Heart Murmur :
It can reflect a more rapid blood flow through the heart valves and no require no further attention when detected in a healthy heart. Innocent murmur can occur-
♤ After strenuous activity or exercise
♤ Due to lack of healthy RBCs due to anemia
♤ During pregnancy , when the heart needs to pump extra blood for the baby
♤ Most innocent murmur happen when the heart muscle is contracting and are classified as Systolic Heart Murmurs.
2) Abnormal Heart Murmur:
It can indicate a defect in the structure of the heart valve, or other heart valve abnormally present since birth or occurring later in life. Abnormal heart murmurs can also be caused by the narrowing and hardening of heart valves, which happens due to age.
Heart murmurs often don't carry any symptoms atall and are only discovered through the physician's ears during a stethoscope examination. When there are symptoms such as shortness of breath, dizziness or blackout - they are often due to an underlying cause , such as damage to the heart valves.
☆☆ When should evaluate the patient for heart murmurs:-
~ Perform a detailed review of medical history .
~ Conduct a clinical examination identifying unique characteristics of the murmur that may help to determine severity .
~ Echocardiogram of heart.
~ Put the patient through further testing if necessary.
~ Know the underlying cause and treat the murmur.