Heart Murmurs

What is a heart murmur?

The sound of your heart beating is the sound of the closure of your heart valves. When there is a problem with a valve (stenosis or regurgitation), the blood flow across the valves becomes turbulent. This causes a sound which is heard as a “murmur” during an examination. Your doctor can usually hear the murmur while listening to your heartbeat using a stethoscope.

There are two types of heart murmurs:

• Diastolic –the heart muscle relaxes between beats
• Systolic—the heart muscle contracts to squeeze the blood through the chambers

What should I do if I’ve been told I have a heart murmur?

Your doctor will listen carefully to your murmur to decide if it needs further investigation. Murmurs can also be caused by other heart conditions besides valve problems. It is a good idea to find out why you have a heart murmur. A series of diagnostic tests can tell if it is okay or if you need medication or another treatment for your heart. Your doctor may refer you to a cardiologist, who may order:

• Cardiac ultrasound (echocardiogram). This test uses ultrasound equipment to visualize the four chambers of the heart and their pumping action as well as the function of the heart valves so if there is a problem your cardiologist can identify it immediately.
• Cardiac CT or Cardiac MRI can help visualize cardiac structure and function and help understand the nature of complex valve disease.

How will my cardiologist treat my heart murmur?

If your murmur does not indicate a serious problem with your heart, then your physician will probably choose to continue to monitor your heart murmur over time. However, if your murmur is a sign of a more serious issue with one of your heart valves, your physician may recommend:

• Medication. Medicine(s) are prescribed to reduce the strain on the heart.
• Valve surgery. This surgery requires your cardiac surgeon to repair or replace the valves.

Heart valve surgery

Your cardiologist will refer you to a cardiac surgeon to repair or replace your heart valve. Your cardiac surgeon will recommend one of the following surgeries, depending on your symptoms and the best probable outcome:

1. Heart valve repair—this is preferable if possible, as your own tissue is better than replacing a heart valve. This is most commonly performed in cases of mitral valve regurgitation (leakage) but may be possible in other situations as well.

2. Heart valve replacement—this can be done using a variety of valves, including mechanical and tissue valves (pig or cow tissue). Learn more about heart valve disease and heart valve surgery.

3. Options currently In Clinical Trial:

• Percutaneous Aortic Valve Replacement. We are one of only a few Centers worldwide in a clinical trial utilizing this technique to treat aortic stenosis. Patients who are identified as high-risk can now undergo a minimally-invasive procedure without the stress of open heart surgery. Minimally-invasive procedures use the fewest and smallest cuts in order to cure or fix the cause of the problem. This leads to faster recovery times for patients and less risk of infection.

Experienced cardiac specialists

The good news is that the cardiologists at Washington Heart and Vascular Services have the expertise and experience to tell what your heart murmur means. The vast majority of patients with heart murmurs do not need surgery. If you do, you should know you are in very good hands. We have the largest number of cardiac surgeons in the Washington, D.C. metropolitan region and offer the best options for you. The Society of Thoracic Surgeons has recently developed a comprehensive rating system that allows for comparisons regarding the quality of cardiac surgery among hospitals across the country. Approximately 15 percent of hospitals receive the “3-star” rating, which denotes the highest category of quality. In the current analysis of national data, the cardiac surgery performance our hospital was found to lie in the highest quality tier, thereby receiving an STS 3-star rating.