Heart murmurs

Diagnosis

Heart murmurs are usually diagnosed during are routine checkup, while the doctor listens to the heart as well as asks about your health condition.

Many following aspects of heart sounds heard through a stethoscope are considered for disease diagnosis:

• Volume: A scale of from 1 to 6 (least to most loud) is used to tell the volume of heart murmurs.
• Location: The murmuring sound tells which part of the heart is affected by the disease and helps confirm if it has spread to some other areas such as the neck or the back.
• Pitch: Heart murmurs might create a high, medium or low pitched voice.
• Timing of the murmur: There are different kinds of heart murmurs depending on the occurrence of the disease. Innocent heart murmurs are mostly systolic murmurs, which occur when blood is pumped out of the heart. Severe murmurs which tell that there is a cardiac problem, on the other hand, are either diastolic murmurs, which occur when blood is filling the heart, or continuous murmurs, which are ones that happen throughout the heartbeat.
• Sound changes. A patient is required to lie down or exercise during diagnosis to let the doctor see how the heart’s sound changes during these activities.

Tests

A doctor might use any of the following tests to find the cause of worrisome heart murmurs:

• Echocardiogram: Shows how the heart is beating and the blood flow in the heart and valves through pictures made with sound waves.
• Chest X–ray: Shows pictures of the heart and lungs to help detect an enlarged heart.
• Electrocardiogram (ECG or EKG): Detects irregularities of electrical activity of the heart. The doctor places electrodes on the chest, the arms or legs to monitor the cardiac electricity, which are connected to a computer to show results.
• Cardiac catheterization: In this procedure, your doctor will insert a catheter into a blood vessel of the groin before guiding it to the heart. Contrast materials might be injected through the catheter for clearer images of blood vessels. Doctors tend to use this procedure after other testing methods have failed to detect heart murmurs.

Treatment

Unlike worrisome heart murmurs that require careful medical attention and treatment with medications and surgery, harmless heart murmurs usually go away on their own without treatment.

Medications

A doctor uses certain medications as follows to treat heart murmurs:

• Anticoagulants: The medications disrupt the forming process of blood clots. The clots raise the risk of strokes and are associated with arrhythmias, which may be a sign of certain defects that cause heart murmurs. There are many options of blood thinners, including warfarin, clopidogrel, apixaban, rivaroxaban and dabigatran.
• Diuretics. The drugs are given to lower blood pressure and treat other conditions that contribute to heart murmurs by preventing fluid buildups inside the body.
• Angiotensin–converting enzyme (ACE) inhibitors. As hypertension provokes symptoms of heart murmurs, this medication will regulate a patient’s blood pressure.
• Beta blockers. Medication to control heart rate and blood pressure. Unlike the past, people who suffer from worrisome heart murmurs nowadays are not required to take antibiotics to prevent heart infections during surgery or dental procedures. A doctor may prescribe antibiotics only for patients who have a high risk of cardiac infection. This includes those who have artificial heart valves, a history of heart valve infections or congenital heart defects.

Surgery or other procedures.

A doctor might recommend surgery to cure the cause of a worrisome heart murmur. For example, if your heart valve is thickening or leaking, resulting in heart murmurs, your doctor might recommend surgery to fix or replace that disordered heart valve.

The process of surgery to repair a heart valve includes:

• Patching a heart valve’s holes
• Separating valve leaflets that are joining together
• Replacing the cords that support heart valve
• Making the valve close normally by removing theexcess valve tissue.
• Making the ring around a valve tighter

Options for heart valve surgery include:

• Open-heart surgery
• Minimally invasive surgery
• Robot-assisted surgery
• Cardiac catheterization

Your doctor will assess your health conditions to determine the best way to perform surgery.