A heart murmur is the sound of turbulent (irregular) blood flowing through your heart's chambers and valves. A healthy heart makes a clear and rhythmic “lub dub” sound. Heart murmurs make a whooshing noise with each heartbeat.

Health care providers can hear turbulence when they listen to your child’s heart. The pattern varies, depending on what causes the murmur.

Heart murmurs are common in children. Most are harmless (innocent) and go away as a child grows up, though some can remain into adulthood. Children and adults with innocent heart murmurs typically have healthy hearts and lead full, active lives.

Less often, a heart murmur indicates a problem with the structure of your child’s heart. If your child’s pediatrician is concerned about a heart murmur, they refer you to a pediatric cardiologist.

The main symptom of a heart murmur is a whooshing noise that can be soft and musical or loud and harsh. Most children with innocent heart murmurs don’t have other symptoms.

Innocent murmurs usually occur during the heartbeat (systolic). They are typically softer, shorter, lower and change with breathing or activity.

Symptoms of Congenital Heart Disease

Murmurs that occur between heartbeats (diastolic) may suggest a congenital heart anomaly. Other signs your child may have a congenital heart anomaly include:

• Bluish tint to nails, lips or skin
• Fatigue
• Feeding problems
• Rapid breathing (tachypnea) or difficulty breathing
• Shortness of breath (dyspnea), especially during physical activity
• Swelling of the legs or abdomen (edema)

Irregular blood flow through the heart causes heart murmurs. This irregularity may occur during typical childhood development or due to a medical condition.

To diagnose a heart murmur, your pediatrician uses a stethoscope to listen carefully to your child’s heart for clues. The location, loudness (volume) and pattern of a heart murmur can indicate how serious it is.

Your pediatrician may also:

• Ask about any related symptoms
• Review your child’s medical and family history
• Do a thorough physical exam
• Measure your child’s blood oxygen level with a pulse oximeter (device that gently clips on your child’s finger)

If your pediatrician suspects congenital heart disease, your child sees a pediatric heart specialist for in-depth evaluation and testing. Newborns with heart murmurs have a higher risk of congenital heart disease than older children. An evaluation by a pediatric heart specialist is important at this age, even if your child has no other symptoms.

Tests that may help your physician diagnose a congenital heart anomaly include:

• Cardiac catheterization: This test uses a thin tube (catheter) inserted through an artery in your child’s leg or neck to reach their heart. Your physician takes measurements and pictures to diagnose a heart anomaly. 
• Echocardiogram: This ultrasound test creates a movie that can detect problems with your child’s heart’s structure and function.
• Electrocardiogram (EKG): This test measures the electrical activity of your child’s heartbeat.
• MRI, CT and X-ray: These imaging tests help your provider see the details of your child’s heart, blood vessels and lungs.

We understand medical tests can be stressful for children. Specialists in our Child Life Program work with you and your child before and during the test to ease anxiety and fear.

Our pediatric heart teams use extensive experience and advanced skills to manage routine and complex heart conditions. They partner with your family to develop the right treatment plan for your child and provide comprehensive guidance and support.

Children with innocent heart murmurs typically do not require any treatment. They can participate in all activities.

A heart murmur caused by a congenital heart disease may or may not need treatment. It depends on the type of heart anomaly and how serious it is. Treatment options for your child may include: