Under normal conditions, the flow of blood through the heart's orifices or chambers is silent, and when listening to the heart, only the sounds (or heart tones) produced by the closure of the heart valves are heard (see Figure 1). However, if there is an anatomical abnormality, such as a narrowed valve, the turbulent flow at the site of the narrowing causes vibrations of the vessels or heart chambers, which are recognized as murmurs during auscultation of the heart. gustsConsequently, heart murmurs are not a heart condition but an auscultatory finding.
Most people learn they have a heart murmur during a routine exam. If your doctor hears a heart murmur, he or she may ask you to hold your breath or change your body position while they listen to your heart with a stethoscope.
The presence of a murmur does not necessarily imply the presence of heart disease, as many people with normal cardiovascular systems experience heart murmurs. Doctors call these murmurs "innocent". Such an innocent murmur is the one first described by the London doctor George Still in 1915. It is a murmur that is often found in infants and children and causes undue concern to parents, as it has not been associated with any heart disease and does not pose any risk to the health of the person being examined. It usually disappears with adulthood, but even if it continues to be heard in adulthood, its clinical significance is negligible.
Innocent murmurs can be heard at all ages, but they are generally easier to hear in young, slender individuals and in pregnant women.
Other heart murmurs are pathological and are due to some heart disease. Common causes of pathological murmurs are:
- Valvular diseases (valve stenosis or insufficiency).
- Pathological communications between the heart chambers (such as ventricular septal defect, see Figure 2).
When the doctor first detects a murmur, he will want to determine whether it is innocent or pathological. For this reason, he will ask you some questions and examine you.
If your murmur is benign, you will not need any further testing. If your doctor thinks your murmur is abnormal or is unsure, he or she may ask you to undergo some tests to clarify the cause of the murmur. The most common test used for this purpose is an echocardiogram (also known as a triplex scan). This method uses ultrasound to image the heart while it is beating. An echocardiogram can check the systolic and diastolic function of the heart, the size of the heart chambers, and the function of the heart valves (see Figure 3).
Treatment depends on the heart condition causing the murmur, as well as the severity of the condition. If your heart condition is not severe, you may not need treatment, and your doctor may recommend simple monitoring.
If your heart condition is severe, you may need treatment that may include surgery or the implantation of a prosthetic valve using a catheter.
In the past, doctors recommended that patients with gingivitis receive prophylactic antibiotics before certain dental or medical procedures. Now, the indications for prophylactic antibiotics have been significantly narrowed. Ask your doctor if you need antibiotics before such procedures.
Main image: The heart consists of four main chambers. The two upper chambers are called the right and left atriums. The two lower chambers are called the right and left ventricles. Between the left atrium and the left ventricle is the mitral valve, and between the right atrium and the right ventricle is the tricuspid valve.
When the heart is functioning normally, blood returns from the body's periphery to the right atrium and from there to the right ventricle. From there, it is pumped to the lungs where it picks up oxygen. The blood is then pumped to the left atrium and then to the left ventricle, where it is pumped to the body's periphery through a blood vessel called the aorta. If a valve is not working properly, it will either allow blood to flow backward in the wrong direction or prevent blood from flowing in the right direction.
Image 2: In patients with a ventricular septal defect, blood flow is observed from the left ventricle to the right.
photo
