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Forum Name: Miscellaneous Cardiology Topics

Question: Heart murmur detected, need for additional follow-up?


 Jamie_brr - Mon May 12, 2008 10:09 pm

I went to the urgent care center about a week ago for a sinus infection. After the P.A. listened to my heart she asked me if i was aware that I have a heart murmur. I wasn't, however when i was a child a doctor had wondered if i did have a slight one, though didn't appear to be concerned. Since switching doctors at 13 (I'm 21 now) no other doctor has ever brought the matter to my attention. The Physicians asssitant said it was no concern as it occured after the first beat, and had something to do with blood continuing to flow through the aorta (I may be mistaken on that part, but she did definately say it had to do with the aorta and that it occured after the first beat). Is this truly a benign finding, or should I consult my primary care physician for a follow-up? Also, will this develop into a problem when I get older? Thank you!

Jamie
 Dr. Chan Lowe - Fri Jul 18, 2008 4:08 pm

User avatar Hi Jamie_brr,

This is a good question. In general, there is a lot of confusion about a heart murmur. A murmur is simply a sound that is heard coming from the heart or related structures. A murmur, in itself, is not a diagnosis only a sign that is heard. The bigger question is what is causing the murmur.

To subdivide this further, there are innocent heart murmurs and pathologic heart murmurs. Innocent heart murmurs are typically caused by blood flowing quickly through the heart or vessels. The occasionally are made from small cords in the heart (that keep the valves from flipping backwards) beginning to hum similar to a piano or guitar string because the blood flow is causing them to vibrate (termed a still's murmur). These murmurs are completely harmless and need no follow up. Often, they follow the first heart sound (as the PA was describing). These murmurs can be heard into adulthood also, particularly in thinner people, although often they "go away" simply because as a person gets bigger there is more bulk mass (muscle, etc.) that keeps us from hearing the murmur (even though it probably actually is still there).

Pathologic murmurs often are more harsh sounding. They can follow the first heart sound or be at other parts of the heart sound. These can be made by blood flowing through a hole or constriction in the heart or blood vessels. They can also be caused by leaky valves. These types of conditions may or may not need treatment.

From the description of the P.A., I suspect your murmur is from an innocent condition; however, I can't be sure. My advise would be to see your primary care physician to have another evaluation. If it sounds concerning you can be referred to a cardiologist for further testing.

Best wishes.

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