Our pediatrician just told me that my child has a heart murmur, Should I be concerned? What exactly is a murmur?
Murmurs are sounds that doctors detect upon cardiac auscultation with the stethoscope. Innocent murmurs are generally considered normal and not associated with any underlying cardiovascular disease. Usually, on cardiac auscultation, only valve closures are heard without any other sounds added.
How does the heart work?: When the semilunar valves (the valves of the vessels that leave the heart, aortic and pulmonary valves) are opened, blood flows out of the heart, this period is called systole in the cardiac cycle. Opening of the semilunar valves coincides with the closing of the intracardiac valves (tricuspid and mitral). Once all the blood is completely out the heart, the relaxation takes place that entails an effect of sucking the blood from the veins to the heart, it is the so-called diastole of the cardiac cycle.
If there are cardiac abnormalities (such as holes, abnormal valve or membrane abnormalities inside the heart), a sound will be produced and is caused by the passage of blood in the abnormal areas, this is a patologic or “organic” murmur. Characteristics of pathologic murmurs include a sound level intense (of grade 3 or louder), a diastolic murmur or an increase in intensity when the patient is standing.
Children have small vibrating murmurs, which generate an innocent or functional murmur, this murmur is not caused by any alteration of the heart.
Innocent heart murmur is related with the elasticity of the heart, the tachycardia inherent in children and the short distance between the thoracic cavity and the heart, although its origin is not completely clear. The characteristics of the innocent murmur are very specific and pediatric cardiologists normally recognize them by auscultation. Sometimes, when the murmur persists, even though it is suspected to be innocent, pediatricians prefer to refer the child to cardiologists to rule out cardiac abnormalities.
If the murmur persists or increases in intensity, it is recommended to show by echocardiography performed by specific pediatric cardiologist. Once intracardiac problems are ruled out, follow-up can be done by the pediatrician, who will confirm their disappearance.
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