Your 3-year-old's doctor discovers a heart murmur during a visit for a mild cold with fever and recommends referral to a pediatric cardiologist. You worry and wonder how your healthy, active child could possibly have a heart problem.
"Finding out that your child has a heart murmur causes a great deal of anxiety," said Dr. Louis Bezold, associate professor of pediatrics and chief of the division of pediatric cardiology, University of Kentucky College of Medicine, and co-director of the Kentucky Children's Heart Center. "It is a common misconception that all murmurs are serious, but this is not the case.
Murmurs are actually extremely common findings in infants and children. In fact, most children will have a murmur at some point during childhood.
According to Bezold, a murmur is simply an extra noise in addition to the normal heart sounds (so-called "lub-dub") heard using a stethoscope. When your doctor listens to your child's heart they will note the location, intensity and other characteristics of the extra sound. Based on the examination, murmurs can be classified in two broad categories: innocent or pathologic.
Innocent murmurs (also known as benign, functional or flow murmurs) are the most common. As their name implies, they are not considered abnormal and have no effect on a child's health. Most innocent murmurs disappear at some point during infancy or childhood. Children with innocent murmurs require no medications or restrictions on activity or diet. In fact, regular physical activity and a healthy diet are very important for heart health. An innocent murmur is not a heart condition.
On the other hand, a pathologic murmur indicates a heart abnormality, including congenital heart defects (present at birth) or heart muscle functional problems. Pathologic murmurs are less common; for example, only about one to two percent of babies are born with a structural heart defect.
Some infants will exhibit signs of a problem early in life. However, some heart defects are detected only because a murmur is noted during childhood. Symptoms that can indicate a heart problem in infancy include feeding problems, fast breathing, poor weight gain and blueness of the tongue or inside of the mouth. Older children may have excessive fatigue or chest pain with physical exertion.
Some pathologic murmurs are due to relatively minor problems that may resolve spontaneously. Treatment for more significant defects may involve medications, antibiotics for dental work, activity restrictions and/or more definitive treatment via surgery or heart catheterization. Fortunately, highly successful potential therapies now exist for most pediatric heart problems.
It is fairly common for a "new" murmur to be noted during a check-up.