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Heart murmurs

Chest sounds - murmurs; Heart sounds - abnormal; Murmur - innocent; Innocent murmur; Systolic heart murmur; Diastolic heart murmur

A heart murmur is a blowing, whooshing, or rasping sound heard during a heartbeat. The sound is caused by turbulent (rough) blood flow through the heart valves or near the heart.

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Heart, section through the middle
Heart valves

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Heartbeat

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Considerations

The heart has 4 chambers:

The heart has valves that close with each heartbeat, causing blood to flow in only one direction. The valves are located between the chambers.

Murmurs can happen for many reasons, such as:

There are several ways in which your health care provider may describe a murmur:

When a murmur is more noticeable, the provider may be able to feel it with the palm of the hand over the heart. This is called a "thrill".

Things the provider will look for in the exam include:

Causes

Many heart murmurs are harmless. These types of murmurs are called innocent murmurs. They will not cause any symptoms or problems. Innocent murmurs DO NOT need treatment.

Other heart murmurs may indicate an abnormality in the heart. These abnormal murmurs can be caused by:

Significant murmurs in children are more likely to be caused by:

Multiple murmurs may result from a combination of heart problems.

Children often have murmurs as a normal part of development. These murmurs DO NOT need treatment. They may include:

What to Expect at Your Office Visit

A provider can listen to your heart sounds by placing a stethoscope on your chest. You will be asked questions about your medical history and symptoms, such as:

The provider may ask you to squat, stand, or hold your breath while bearing down or gripping something with your hands to listen to your heart.

The following tests may be done:

Related Information

Echocardiogram
Aortic stenosis

References

Fang JC, O'Gara PT. History and physical examination: an evidence-based approach. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2018:chap 10.

Goldman L. Approach to the patient with possible cardiovascular disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 51.

Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA/ACC Focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2017;135(25):e1159-e1195. PMID: 28298458 www.ncbi.nlm.nih.gov/pubmed/28298458.

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Review Date: 5/16/2018  

Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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