Signs and Symptoms of Heart Murmurs
People with a heart murmur do not have any other signs and symptoms of a heart problem. The murmur is usually innocent (harmless). Some people with a heart murmur also have signs and symptoms of a heart problem. The signs and symptoms may include: Blue coloring of the skin, especially on the fingertips and inside the mouth Poor eating and failure to grow normally (in infants) Fastbreathing, Excessive sweating, Chest pain, Dizziness, Shortness of breath, Fainting, Fatigue (feeling very tired). The signs and symptoms depend on the cause and the severity of the problem causing the murmur.
The Diagnosis of Heart Murmurs
When the Doctors use a stethoscope to listen to heart sounds and hear murmurs. They often notice innocent heart murmurs during routine checkups or physical exams. Doctors may also find abnormal murmurs during routine checkups. Murmurs caused by congenital heart disease are often heard at birth or during infancy. Doctors may hear murmurs caused by other heart problems at any age. Doctors usually refer people with abnormal murmurs to a heart specialist (a pediatric cardiologist or a cardiologist) for further evaluation and testing. Physical Examination Doctors listen carefully to the heart with a stethoscope to help decide if a murmur is innocent or abnormal. They listen to the loudness, location, and timing of the murmur in order to classify and describe the sound. This helps the doctor begin to diagnose the cause of the murmur. The doctor also: Takes a medical and family history and Does a complete physical exam, looking for signs of illness or physical problems (such as blue coloring of the skin, delayed growth, and feeding problems in an infant) Asks about symptoms such as chest pain, shortness of breath (especially with exercise), dizziness, or fainting.Evaluation of Murmurs. When evaluating a heart murmur, the doctor pays attention to a number of things, including: How faint or loud the sound is. The doctor grades the murmur on a 1Ð6 scale (1 is very faint and 6 is very loud). When the sound occurs in the cycle of the heartbeat. Exactly where the sound is heard in the chest and if it can also be heard in the neck or back. Whether the sound has a high, medium, or low pitch. How long the sound lasts. How breathing, exercise, or change of body position affects the sound.
The Classification of the Murmur
When the Doctors classify murmurs as: Systolic--heard when the heart is squeezing and pumping blood out of the heart.Diastolic--heard when the heart is relaxing and filling with blood. Diastolic murmurs are often a sign of a heart defect or heart disease and should be further evaluated.Continuous--heard during the entire heartbeat. These are often a sign of a heart defect or heart disease and should be further evaluated. Tests are using when doctors hear a murmur that might be abnormal, they order tests such as:Chest x-ray. A chest x-ray takes a picture of your heart and lungs. It can show if the heart is enlarged and can show some problems of the heart and lungs. Electrocardiogram (ECG). This test is used to measure the rate and regularity of your heartbeat. The ECG can help rule out a variety of heart problems. A heart specialist--a pediatric cardiologist or a cardiologist--will most likely do the followup testing. These tests might include:Echocardiogram, a test that uses ultrasound (sound waves) to allow doctors to view your heart as it pumps and relaxes. The echocardiogram is more detailed than an x-ray image and shows the structure and function of the heart. In some cases, transesophageal echocardiography (TEE) might be needed to get a better view of the heart. In TEE, the doctor inserts an ultrasound probe down the throat into the esophagus after the patient is sedated.Cardiac catheterization and angiography.
The Cardiac catheterization is a procedure in which a catheter, a thin flexible tube, is passed through an artery or vein at the top of your leg (groin) or in your arm to reach the heart, after you are sedated. This allows measurement of pressure inside the heart and blood vessels Angiography involves injecting a dye that can be seen using x-ray. This helps the doctor see the flow of blood through the heart and blood vessels.
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