Heart Murmur in Children

Heart valves closing cause the sound of your child’s heartbeat. The valves control blood flow as it moves from chamber to chamber and out of the heart. An out-of-the-ordinary sound in between each heartbeat is called a murmur.

Remarkable Care for Kids

• Committed to compassionate care: The pediatric cardiologists in our Pediatric Cardiology/Pediatric Congenital Heart Disease Program dedicate themselves to delivering special care for little hearts that need attention. We focus on personalized care of young patients — from fetuses to adults — with congenital and acquired heart conditions that may cause heart murmurs.
• Minimally invasive treatments: At Rush, open-heart surgery is not our go-to treatment plan for children with heart conditions. Whenever possible, our pediatric cardiologists at Rush University Children’s Hospital opt for procedures that use smaller incisions, shorter recovery times and less risk of infection.
• Care close to home: Pediatric cardiologists at Rush University Children’s Hospital are able to see patients at a number of convenient locations. They are available to see patients at our Rush campus in Chicago, Rush Oak Park Hospital, Rush Copley Medical Center in Aurora, and at satellite locations throughout the city and the suburbs, including Evergreen Park, Joliet, Hoffman Estates, Tinley Park and Crown Point, IN.

What is a heart murmur in children?

A heart murmur in children can make a blowing, swishing or rasping noise. Rough or turbulent blood flow near the heart or through its valves causes the sound.

The extra sounds can be classified in the following two ways:

• Harmless or innocent murmurs: These generally happen when blood flows quicker than normal through the heart during rapid growth in children, and it does not cause symptoms.
• Abnormal murmurs: These may indicate a serious heart condition such as a congenital (present at birth) heart defect. This type of murmur can cause chronic cough, fainting, bluish skin or shortness of breath in your child.

Many heart murmurs in children are innocent murmurs and quite normal. In fact, children often have murmurs as part of their development. However, abnormal murmurs may require treatment, and can be caused by a variety of congenital heart conditions.

Heart murmur causes

Problems with structures of the heart cause significant heart murmurs in children, particularly at birth. Congenital causes may include the following:

• Atrial septal defect: A hole in the wall between the upper heart chambers (atria) causing blood to flow between them reducing oxygen in the blood that goes to the body.
• Coarctation of the aorta: The aorta, the major heart artery, is too narrow making it hard for blood to pass through.
• Patent ductus arteriosus: A blood vessel that routes blood away from an infant’s lungs before birth and becomes unnecessary after birth when the lungs fill with air remains open resulting in abnormal blood flow causing breathing difficulty.
• Ventricular septal defect: A hole in the wall between the lower heart chambers (ventricles) causing too much blood to be pumped to the lungs resulting in heart failure.

Care for heart murmurs in children at Rush

Diagnosing a heart murmur in your child

If your child’s pediatrician detects a heart murmur, they’ll need to listen to the heart for loudness, timing and location of the murmur. This can help determine whether it’s an innocent or more serious murmur.

During the exam, your child’s pediatrician may look for answers to the following questions:

• Does the murmur happen when the heart is contracting or resting?
• Does it change when your child moves?
• Does it last throughout the heartbeat?
• Where is the murmur heard the loudest?
• Can it be heard in the neck, on the back or other parts of the chest?

Harmless heart murmurs don’t require treatment. However, your child’s pediatrician may refer your child to a pediatric cardiologist if it’s clear your child has a more serious condition. Your child’s pediatric cardiologist may do tests to identify heart rhythms or structural problems and to see how well your child’s heart works.

These tests may include the following:

• Chest X-ray: To identify an enlarged heart
• Electrocardiogram (EKG):  A painless test that measures the electrical activity of your child’s heartbeat
• Echocardiogram: Creates pictures of your child’s heart using high-frequency soundwaves or ultrasound

If the results of these tests indicate a more serious condition, your child’s cardiologist will work with you and your child to create a personalized treatment plan.

Treatment for heart murmurs in children

Treatment is not necessary for the heart murmur itself. It’s typically the heart condition that’s causing the murmur that requires treatment. Some conditions can repair themselves over time, such as a hole in the wall of the heart that closes as your child grows.

If your child needs treatment for a heart condition, it may include the following:

• Medication: Your child may need oral medications to help with symptoms like shortness of breath or poor weight gain prior to a procedure or surgery.
• Cardiac catheterization: A procedure where a catheter (thin, hollow tube) is placed into a blood vessel then a small coil or closure device is threaded through the catheter to block blood flow and ideally avoid surgery
• Heart surgery: To open a narrow aorta, close a wall with stitches or a patch, or tie off an open blood vessel