Heart Murmurs In Children

Heart murmurs in children are quite common. In fact, Up to 10% of all children have a heart murmur. It is reassuring to know that in almost all cases these murmurs are referred to as “innocent or functional”.

What exactly is a murmur?

A murmur is a heart sound heard when a doctor examines the chest with a stethoscope. There are normal heart sounds that we recognize and at times, there are other types of sounds or noises that the heart makes as it pumps the blood. One of these other sounds is called a murmur. In most children, the functional murmur represents the noise made by the blood as it passes through a child’s rapidly beating and growing heart. Children’s heart rates are much quicker than adults. A newborn’s heart rate, for example, is about 120-140 per minute, as compared to the average adult’s rate of 72 beats per minute.

Is a murmur dangerous or serious?

An innocent murmur is not dangerous and poses no problems at all. However, more rarely an “organic murmur” can signify a problem such as leaky or defective heart valves or chambers (ventricles or atria). Most of these types of heart defects are congenital. In other words, the child was born with a malformation. Again it is important to stress that these are only found in very few children with murmurs.

The difference between an innocent murmur and something more serious

In most children, a simple physical examination can confirm that the murmur is functional. For example, we know that a functional murmur usually changes in its sound intensity under varying circumstances; The murmur becomes louder when the heart beats faster, for example during a fever, during physical activity, during changes in body position or if the child is nervous. On the other hand, innocent murmurs become less intense or softer when a child is sleeping or calm. Also, there are no symptoms of heart problems. Symptoms of possible heart problems (known as cardiac or heart symptoms) in children include:

  • Blue lips and/or fingers
  • Poor feeding
  • Difficulty with exercise

Although these symptoms can be caused by other conditions, if your child has any of these, or you have reason to believe there is a heart problem, please consult your doctor.

In most cases, a physician can easily diagnose a functional murmur just by the absence of cardiac symptoms and a normal physical examination. However, some children may require special tests. An ECG(Electrocardiogram) and an Echocardiogram(ultrasound of the heart) are the 2 most commonly performed. In most children, these tests are normal.

What if a child has a heart defect or problem? The treatment approach depends on the type of problem and the degree to which it affects the child’s health. In some cases, there is no treatment while in others the treatment ranges from medications to surgery.

Conclusion: Innocent or functional murmurs are of no consequence to a child’s health, require no specific treatment or precautions, and usually disappear with age.



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Pediatrician DR.PAUL Roumeliotis is certified by the American Board of Pediatrics and Royal College of Physicians and Surgeons of Canada. The information provided above is designed to be an educational aid only. It is not intended to replace the advice and care of your child’s physician, nor is it intended to be used for medical diagnosis or treatment. If you suspect that your child has a medical condition always consult a physician.