Heart murmurs: The good, the bad, and the ugly

Whenever a parent hears that their child has a heart murmur it is a scary feeling. Many questions and concerns come into focus very quickly. The word murmur is so often misused that the word itself can cause great anxiety. Murmur just means an extra sound in the heart cycle that we hear between the “lub” and the “dub”. It is typically described as a “whooshing” sound like hearing water in a hose or a faucet.

Sometimes children have murmurs because they have heart problems. Many times they have heart murmurs that are only sounds and do not represent real or true heart disease. Current estimates are that murmurs occur in ~30-40% of children at some time during childhood. The current best estimates of congenital heart disease in the pediatric population are ~8-10 per 1000 live births. That means our task is to sort out roughly ~0.5% vs. 50%.

When I think of heart murmurs I think of snakes…I know that sounds weird at first but hear me out. Most folks understand that only a few species of snakes in the world are poisonous and most of those species usually live far away from humans. However, if you ever encounter a snake those logical thoughts fly out the window…this snake in front of my HAS to be poisonous. That same feeling is common with murmurs. While we understand as caregivers and parents that many murmurs are innocent and do not represent disease…what if the one in MY child is BAD!

This is normal and understandable. That is why we are careful and thorough when you come see us in the office to make sure that sound we hear is not a problem. And if it does represent a heart problem we can get started that second working together to make it better.

We use the a combination of a careful history and physical exam along with an ECG and Echocardiogram to fully understand all aspects of a child’s heart and circulation. That way when we are finished we can be confident in our diagnosis. In this way we can sort out the good guys from the bad guys and hopefully put everyone’s mind at ease that there are NO rattlesnakes to be found!

Dr. Day

Posted by Dr. Penn Laird Jr. .

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