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.
Heart murmurs in children are very common. A heart murmur just means a sound. Some heart murmurs are sounds produced by actual defects or abnormalities with the heart. For example, a ventricular septal defect (a hole in the wall separating the lower 2 chambers of the heart) makes a very specific noise as blood travels through the hole. Abnormalities with heart valves like aortic valve stenosis can also produce heart murmurs as blood flows past the defective valve. On the other hand, many heart murmurs are what we call innocent heart murmurs. With an innocent heart murmur, the heart is perfectly normal. The murmur in this case is simply the normal sound that blood is making as it flows through the heart.
Questions about an enlarged heart come up fairly often. Not infrequently a child is referred because a chest x-ray demonstrates an "enlarged heart". Likewise, I often hear from parents who tell me that they had a relative who was diagnosed with an enlarged heart. So, what is an enlarged heart?
From time to time we evaluate children who are referred for an irregular heartbeat. This term typically refers to a heart rhythm that does not seem quite regular. An irregular heart beat is a little different from palpitations. The term palpitations refers to a sensation that the heart is not beating normally. Children with palpitations may feel their heart beating rapidly, pausing, or skipping beats. An irregular heartbeat, on the other hand, is usually something that a doctor hears when listening to the heart. Many children suspected of having irregular heartbeats may feel perfectly fine.
This question comes up from time to time, sometimes in the midst of a serious discussion but more often than not as part of a lighthearted conversation. It often gets disputed when cardiologists and neurologists get together! In fact, I remember wondering about it as a child watching the Wizard of Oz!