A heart murmur is an additional sound that occurs between heartbeats and can usually be detected with a stethoscope. Murmurs are classified as diastolic, systolic, and continuous, depending on when they occur in the heartbeat cycle. A systolic heart murmur occurs when muscles contract, pushing blood out of the heart. It starts before or during the first sound of the heartbeat and ends before or during the second sound.
Most heart murmurs are innocent, and many children are diagnosed with a murmur at some point in their life. Murmurs can also be caused by factors such as high blood pressure, anemia, pregnancy, fever, and an overactive thyroid. Most of these murmurs go away on their own, and even if they remain, they do not require any treatment.
A systolic heart murmur can be innocent or abnormal. A routine exam with a stethoscope can usually tell the difference. When there is a murmur, the doctor will check the length of the murmur, when and where it occurs, and whether it has a high, medium, or low pitch. You will also see if the sound can be heard in the neck and back, as well as the chest, and if a change in the patient's position affects the murmur. The exam will also include building a history of the patient and looking for any additional signs of heart disease, such as blue skin color, shortness of breath, dizziness, and fainting.
If an abnormal murmur appears to be present, the patient will usually be referred to a cardiologist. Additional tests, such as an electrocardiogram (EKG) and echocardiography, are used to confirm the initial diagnosis and determine what is causing the murmur. An EKG records the electrical activity of the heart and shows the speed and rhythm of the heartbeat. Echocardiography uses sound waves to create an image of the heart that reveals how the valves and chambers work. Treatment of an abnormal murmur usually does not involve treating the murmur itself, but rather the underlying physical cause.
Your doctor will rate your systolic heart murmur on a scale of one to six, depending on its noise level. A 1/6 systolic heart murmur is weak while a 6/6 murmur is very loud. A systolic heart murmur is classified as an ejection murmur, which comes from the valves and surrounding structures, or a regurgitant murmur that occurs when blood flows from the high-pressure chamber to the low-pressure chamber of the heart.
A systolic heart murmur can be further classified as functional or organic. A functional murmur is found in a heart without abnormalities and is generally innocent. Functional murmurs caused by physical conditions such as anemia, pregnancy, thyroid malfunction, or high blood pressure tend to disappear once the health problem is resolved. An organic systolic heart murmur is the result of structural defects in the heart or major vessels. Abnormal heart murmurs in children are usually related to a congenital heart defect; in adults, they are usually caused by heart valve problems related to age, infection, or disease.