YOUR CHILD’S HEALTH: HEART MURMURS

A heart murmur is a noise heard in addition to the normal heartbeats.

Cause

The commonest cause of a murmur in children is an ‘innocent murmur’, which is the result of turbulence or vibration when the blood flows through the heart valves. This can occur, for example, when the child has a fever. The child’s heart is normal, and the murmur usually disappears with time.

Other heart murmurs can signify heart disease, which can either be present from birth (congenital) or acquired later in life. These murmurs are usually caused by aberrant blood flow through a hole in the wall between the heart chambers, or through faulty valves.

Clinical features

A child who has an innocent murmur will have absolutely no symptoms of heart disease. The child is perfectly normal. A child who has a significant murmur, will usually have characteristic symptoms related to heart disease. These may include breathlessness and blueness of the lips and of the fingers and toes. With some congenital abnormalities of the heart, these symptoms may appear immediately or soon after birth.

Investigations

If there is any uncertainty about the significance of your child’s murmur, your doctor may order an ECG and a chest X-ray. Referral to a paediatric cardiologist may be advised, and an echocardiogram, which is an ultrasound of the heart, may be performed.

Treatment

A child with an innocent murmur does not require any treatment. On the other hand, a child with heart- disease invariably requires some form of treatment, which can range from medication to surgery, depending on the nature and severity of the disorder.

The management of heart problems in children is a highly specialised field of medicine. Your family doctor can provide you with further information at your request.

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