Heart murmurs in children are very common. As many as half of all children will have a heart murmur at some point before 18 years of age. It is important to understand what causes a heart murmur and what needs to be done to evaluate them.
What is a heart murmur? Every time the heart beats, two normal sounds are generated that can be heard using a stethoscope. A heart murmur is an extra sound that is created by the sound of blood flowing through the heart. The most common heart murmur (innocent or benign murmur) is caused by normal blood flowing through the heart. These innocent murmurs can be heard at any time throughout childhood (birth to adolescence) and are frequently heard for the first time if a child has an illness, especially if associated with a fever.
Innocent murmurs may simply diagnosed with a health care provider listening to your child’s heart or may involve other testing, such as an electrocardiogram or echocardiogram. Innocent murmurs do not affect your child’s health and will not affect his or her development. A child with an innocent murmur will have no restrictions and will not need to be followed by a pediatric cardiologist. If your pediatrician or care provider isn’t sure what is causing the murmur they may refer you to a pediatric cardiologist to evaluate your child’s murmur.
Heart murmurs may also be caused by forms of congenital heart disease (CHD). CHD includes abnormalities of the structure of the heart. CHD occurs in roughly 1 in 100 children born and range from relatively minor small holes in the heart to more complicated problems. Some forms of CHD resolve on their own while other may require more advanced treatments.
What to expect from the pediatric cardiologist or pediatric cardiology nurse practitioner? During your child’s visit, you will be asked questions about your child’s progress and development, if there are any symptoms or concerns that you may have, along with questions regarding your family’s medical history. For example you may be asked, “Have any members of your family had a heart problem?” and, if so, “Did they require any treatments such as surgery?” Specific to your child, you may be asked “Does your pediatrician have any concern for your child’s growth?” or “Does your child easily become short of breath?”
After talking with you the pediatric cardiologist or cardiology nurse practitioner will do a full physical examination, including listening carefully to your child’s heart and lungs. Other tests they may obtain include an electrocardiogram (EKG) which involves placing stickers on your child’s chest to measure the electrical activity of the heart. They may want to obtain a chest x-ray and may choose to perform an echocardiogram of the heart, which uses ultrasound waves to create pictures of the heart. The cardiologist will explain if anything is not normal in your child’s heart, what symptoms to watch for, and when to schedule follow up appointments.
Your cardiology provider will carefully outline with you how often your child will need to be followed and if any additional tests or procedures are necessary. Fortunately, it is rare that the activities of children with CHD are limited. Lastly, the cardiologist will send a letter with the details of the visit to your child’s primary provider.
Hearing that your child has a heart murmur can be alarming. Your pediatric cardiology team is here to support you and to educate you on what is going on and if any further follow up is needed. In partnership with your primary care provider we are here to provide your child with the highest quality care.
For more information about the Heart Center at Nationwide Children's Hospital, click here.