The vast majority of heart murmurs are not serious, and happen without any kind of disease, being called physiological or innocent, arising due to the natural turbulence of the blood as it passes through the heart.
This type of murmur is very common in babies and children, and happens because the structures of the heart are still developing and may be disproportionate, so most of them disappear over the years, with growth.
However, when the heart murmur is accompanied by some symptoms, such as shortness of breath, difficulty in eating, palpitations or purplish mouth and hands, it may be caused by some disease, and in these cases, it is necessary to consult a cardiologist for investigate the cause, through tests such as echocardiography, and start treatment. These cases can sometimes only be identified in adulthood when doing routine exams, for example.
Find out more details on how to identify heart murmur symptoms.
Degree of heart murmur
There are 6 main types of heart murmur, which vary according to their intensity:
- Grade 1: very quiet murmur that can be heard slightly by the doctor when performing auscultation; Grade 2: it is easily identified when listening to a specific location; Grade 3: it is a moderately loud breath; Grade 4: loud murmur that can be heard with the stethoscope over a large area; Grade 5: loud murmur that is associated with the sensation of vibration in the heart region; Grade 6: can be heard with the ear slightly against the chest.
Generally, the greater the intensity and degree of the murmur, the greater the chances of a heart problem. In such cases, the doctor may order several tests to assess the functioning of the heart and to assess whether there are any changes that need treatment.
Main causes of murmur
Possible causes of a heart murmur include physiological or innocent changes, in which there is no disease and which can disappear over time, especially in children; or d congenital effects on the heart, in which the heart does not develop properly, with defects in its valves or muscles, as can happen in Down syndrome, congenital rubella or alcoholism by the mother, for example.
Other examples of congenital disease are the persistence of the ductus arteriosus, mitral valve prolapse, valve stenosis, interatrial communication, interventricular communication, atrioventricular septal defects and Fallot's tetralogy.
In premature babies, cases of heart murmur may also arise, as the child may be born without the full development of the heart. In these cases, treatment is also done depending on the type of change and the child's symptoms.
When treatment is needed
In cases of innocent murmur, treatment is not necessary, only a follow-up with the pediatrician, as instructed by him.
However, when the heart murmur is caused by a heart disease, it is necessary to start treatment, which varies according to its cause, and is guided by the cardiologist. So, some of the options are:
- Use of medicines: some medicines are used to treat certain defects in the heart, such as Ibuprofen used to treat persistent ductus arteriosus, or others of a diuretic type, such as furosemide, and antihypertensives, such as propranolol and enalapril, which can be used to treating and controlling symptoms of heart failure, for example; Surgery: may be indicated to treat the most serious cases of heart defects, which do not improve with the initial treatment or which are more serious. Thus, the possibilities are:
- Correction of the valve by balloon, made with the introduction of a catheter and insufflation of a balloon, being more indicated for cases of narrowing of valves; Correction by surgery, made with the opening of the chest and heart to correct the defect in the valve, in the muscle or to change the defective valve.
Generally, recovery from surgery is easy and quick, requiring only a period of hospital stay of a few days, until discharge home, after release from the pediatrician or cardiologist.
It may also be necessary to carry out a rehabilitation with physiotherapy, in addition to returning with the doctor for reassessments. Know better when heart murmur surgery is indicated.
