Heart Murmurs in Children

Should you be worried if your child is diagnosed with a heart murmur? At least 50 percent of children have a heart murmur at some point during their life. Learn what a heart murmur is and how to distinguish normal murmurs from abnormal murmurs.

What is a heart murmur?

Murmurs are extra or unusual sounds made by blood circulating through the heart’s chambers or valves, or through blood vessels near the heart.

What causes a heart murmur?

Heart murmurs may be heard in a normal healthy heart of a child, or they may be caused by a number of factors or diseases, including:

What are the different types of murmurs?

Your child’s health care provider will evaluate a murmur based on several factors. Murmurs are analyzed for pitch, loudness, location and duration. They also are graded according to their intensity (on a scale of 1 to 6, with 1 being very faint and 6 being very loud).

Types of murmurs include the following:

  • Systolic murmur. A heart murmur that occurs during a heart muscle contraction or when blood is pushed out from the heart to the body.
  • Diastolic murmur. A heart murmur that occurs during heart muscle relaxation between beats or when heart chambers are re-filling before the next contraction.
  • Continuous murmur. A heart murmur that occurs throughout the cardiac cycle, during contraction and relaxation.

Heart murmurs can change and be heard or not heard at different times. With some large heart defects, newborn babies may have a very faint or no murmur at all because of nearly equal pressures on both sides of the heart. In addition, murmurs may be inconsistent and difficult to hear in an infant who is agitated or crying. Thus, sometimes murmurs may be missed or not detected. For these reasons, your child’s doctor will listen and evaluate your child’s heart sounds multiple times throughout your child’s growth and development.

Do all murmurs signify heart disease?

No, not all heart murmurs mean heart disease. Sometimes, a murmur may be heard in a normal child as the strong, healthy heart pumps blood into the vessels. This is known as an “innocent murmur.” It usually resolves as the child grows.

Murmurs can also be heard in a child with no heart disease but who has a fever or who is anemic; these murmurs often go away when the underlying problem is treated.

What tests may be used to evaluate a heart murmur?

  • Echocardiogram (Echo): An ultrasound procedure that evaluates the structure and function of the heart. An ultrasound generates pictures using sound waves. Learn more about echocardiogram.
  • Electrocardiogram (ECG): A fairly quick and simple test using stickers placed on the chest that can detect and record the electrical activity of the heart. Learn more about electrocardiogram.

What is the treatment for a heart murmur?

Many heart murmurs are normal, extra sounds in children with strong, healthy hearts. These children require no treatment. Some of these heart murmurs may resolve over time. Even if there is a hole or structural defect found in the heart, it may close as your child grows. However, some defects will require surgery to correct. Others are caused by conditions not related to the heart, such as having a fever or anemia. In these cases, the heart murmur will lessen or resolve as the underlying condition is treated.

Helpful Facts About Heart Murmurs

Check out these helpful facts about heart murmurs in children from Dr. Nita Doshi, pediatric cardiologist at CHOC.

CHOC heart specialist