7 Heart Murmur Symptoms You Should Never Ignore

A heart murmur is an unusual sound heard during a heartbeat cycle, often described as a whooshing or swishing noise. While many heart murmurs are harmless (innocent murmurs), some can indicate underlying cardiovascular problems that require medical attention. Understanding the symptoms associated with heart murmurs is crucial for early detection and proper management of potential heart conditions.

Heart murmurs occur when blood flows turbulently through the heart valves or chambers. They are commonly detected during routine physical examinations using a stethoscope. While some people with heart murmurs experience no symptoms at all, others may exhibit various signs that warrant further investigation. This article explores the most common symptoms associated with heart murmurs that you should be aware of.

1. Shortness of Breath (Dyspnea)

Shortness of breath is one of the most common symptoms experienced by people with significant heart murmurs. This occurs when the heart cannot pump blood efficiently due to valve problems or structural abnormalities.

You may notice breathlessness during physical activities such as climbing stairs, walking briskly, or exercising. In more severe cases, shortness of breath can occur even during rest or while lying down flat, a condition known as orthopnea. This happens because abnormal blood flow through the heart reduces oxygen delivery to your body’s tissues.

The severity of dyspnea often correlates with the underlying heart condition’s progression. If you find yourself becoming increasingly winded during activities that previously didn’t cause breathing difficulties, it’s essential to consult a healthcare provider for evaluation.

2. Chest Pain or Discomfort

Chest pain associated with heart murmurs can manifest in various ways, from mild discomfort to severe pressure or tightness. This symptom typically indicates that the heart muscle isn’t receiving adequate blood supply or is working harder than normal to compensate for valve dysfunction.

The chest pain may feel like:

• A squeezing or pressing sensation in the chest
• Sharp or stabbing pains that worsen with physical activity
• Discomfort that radiates to the arms, neck, jaw, or back
• A heavy feeling in the chest area

This symptom should never be ignored, especially if accompanied by other warning signs like sweating, nausea, or dizziness. Chest pain related to heart murmurs may indicate conditions such as aortic stenosis or mitral valve prolapse that require immediate medical evaluation.

3. Fatigue and Weakness

Chronic fatigue and persistent weakness are frequently reported by individuals with significant heart murmurs. When the heart cannot pump blood effectively due to valve abnormalities, your body’s organs and muscles don’t receive sufficient oxygen and nutrients to function optimally.

This fatigue differs from normal tiredness after a busy day. People with heart murmur-related fatigue often describe feeling exhausted even after adequate rest or minimal physical exertion. You might find it challenging to complete everyday tasks that previously seemed effortless, such as grocery shopping, household chores, or walking short distances.

The weakness may be particularly noticeable in your arms and legs, making them feel heavy or difficult to move. This symptom can significantly impact your quality of life and daily functioning, making it important to discuss with your doctor.

4. Dizziness and Lightheadedness

Feeling dizzy or lightheaded is another common symptom that can accompany heart murmurs, particularly those caused by valve problems that affect blood flow to the brain and other vital organs.

These sensations occur when your brain temporarily receives insufficient oxygen-rich blood. You may experience:

• Feeling unsteady or off-balance when standing up quickly
• A spinning sensation (vertigo)
• The feeling that you might faint or pass out
• Visual disturbances or seeing spots

Dizziness associated with heart murmurs may worsen during physical activity or when changing positions rapidly. Some people experience these symptoms more frequently in the morning or after meals. If you experience frequent dizzy spells, especially if accompanied by fainting episodes, seek medical attention promptly as this may indicate a serious heart valve problem.

5. Rapid or Irregular Heartbeat (Palpitations)

Heart palpitations are sensations of your heart beating too fast, too hard, or irregularly. People with heart murmurs often describe feeling like their heart is pounding, fluttering, or skipping beats in their chest.

These palpitations occur because abnormal valve function can trigger irregular heart rhythms (arrhythmias) or cause the heart to work harder to maintain adequate blood flow throughout the body. You might notice your heartbeat becomes more apparent during rest, especially when lying down at night, or it may be triggered by physical exertion, stress, or caffeine consumption.

While occasional palpitations are common and often harmless, persistent or frequent irregular heartbeats associated with heart murmurs should be evaluated by a cardiologist. They may indicate underlying conditions such as atrial fibrillation or ventricular arrhythmias that require monitoring and management.

6. Swelling in the Legs, Ankles, or Feet (Edema)

Swelling in the lower extremities, medically termed peripheral edema, can be a sign that a heart murmur is affecting your heart’s pumping ability. When the heart cannot effectively circulate blood, fluid begins to accumulate in the body’s tissues, particularly in the legs, ankles, and feet due to gravity.

You may notice:

• Puffiness or swelling that worsens throughout the day
• Indentations remaining on your skin after pressing it (pitting edema)
• Shoes and socks feeling tighter than usual
• Shiny or stretched-looking skin over swollen areas
• Difficulty fitting into shoes that normally fit comfortably

Edema related to heart murmurs typically develops gradually and may be accompanied by weight gain due to fluid retention. In more advanced cases, swelling can also occur in the abdomen (ascites) or throughout the body. This symptom indicates that the heart murmur may be causing heart failure and requires immediate medical attention.

7. Cyanosis (Bluish Skin Discoloration)

Cyanosis refers to a bluish or purplish discoloration of the skin, lips, or nail beds, indicating that your blood isn’t carrying enough oxygen. This symptom is more commonly associated with congenital heart defects that cause heart murmurs but can also occur with severe acquired valve disease.

Cyanosis occurs when oxygen-poor blood circulates through your body or when oxygenated and deoxygenated blood mix abnormally within the heart. The bluish tint is most noticeable in areas where blood vessels are close to the skin surface, such as:

• Lips and tongue
• Fingertips and toes
• Nose and earlobes
• Mucous membranes inside the mouth

In infants and children with congenital heart defects causing murmurs, cyanosis may become more apparent during crying, feeding, or physical activity when oxygen demands increase. This is a serious symptom that requires urgent medical evaluation, as it indicates significant oxygen deprivation that can affect vital organs.

Main Causes of Heart Murmurs

Heart murmurs can be classified into two main categories: innocent (harmless) murmurs and abnormal murmurs. Understanding the causes helps determine whether symptoms warrant concern.

Innocent Heart Murmurs

Innocent murmurs are common and don’t indicate heart disease. They can be caused by:

• Increased blood flow: During pregnancy, fever, anemia, hyperthyroidism, or rapid growth in children and adolescents
• Physical activity: Exercise or excitement that increases heart rate and blood flow
• Normal anatomical variations: Structural differences that don’t affect heart function

Abnormal Heart Murmurs

Abnormal murmurs result from structural heart problems and may include:

• Valve disease: Stenosis (narrowing) or regurgitation (leaking) of heart valves including aortic, mitral, tricuspid, or pulmonary valves
• Congenital heart defects: Structural abnormalities present from birth such as atrial septal defect, ventricular septal defect, patent ductus arteriosus, or tetralogy of Fallot
• Infections: Endocarditis (infection of the heart valves) that damages valve tissue
• Rheumatic fever: A complication of untreated strep throat that can damage heart valves
• Age-related changes: Calcification and degeneration of heart valves that occur with aging
• Cardiomyopathy: Diseases of the heart muscle that affect heart structure and function

Prevention of Heart Murmurs

While congenital heart defects causing murmurs cannot be prevented, you can take steps to reduce your risk of developing acquired heart conditions that lead to abnormal murmurs:

Maintain Heart Health

• Adopt a heart-healthy diet: Focus on fruits, vegetables, whole grains, lean proteins, and healthy fats while limiting sodium, saturated fats, and processed foods
• Exercise regularly: Aim for at least 150 minutes of moderate-intensity aerobic activity weekly
• Maintain healthy weight: Obesity increases stress on the heart and risk of valve disease
• Control blood pressure: High blood pressure can damage heart valves over time
• Manage cholesterol levels: High cholesterol contributes to valve calcification

Prevent Infections

• Practice good dental hygiene: Brush and floss daily and get regular dental checkups to prevent bacteria from entering the bloodstream
• Treat infections promptly: Seek medical care for strep throat and other infections to prevent complications like rheumatic fever
• Inform healthcare providers: If you have a known heart valve problem, inform your dentist and doctors so they can take appropriate precautions during procedures

Lifestyle Modifications

• Avoid smoking: Tobacco use damages blood vessels and increases heart disease risk
• Limit alcohol consumption: Excessive alcohol can weaken the heart muscle
• Manage stress: Chronic stress affects heart health and blood pressure
• Control diabetes: High blood sugar levels can contribute to cardiovascular complications

Frequently Asked Questions

Can a heart murmur go away on its own?

Yes, innocent heart murmurs, particularly those in children, often disappear as the child grows. However, abnormal murmurs caused by structural heart problems typically don’t resolve without treatment and may worsen over time.

Are all heart murmurs dangerous?

No, many heart murmurs are innocent and don’t indicate any health problems. However, abnormal murmurs can signal serious heart conditions. A healthcare provider can determine whether a murmur is harmless or requires further evaluation through physical examination and diagnostic tests.

Can you live a normal life with a heart murmur?

Most people with innocent heart murmurs live completely normal lives without restrictions. Those with abnormal murmurs may also live normal lives depending on the underlying cause and severity. Some may need regular monitoring, lifestyle modifications, or medical interventions, but many continue with their usual activities.

What does a heart murmur feel like?

Most people cannot feel their heart murmur. The sound is typically detected by a doctor using a stethoscope. However, symptoms associated with the underlying cause of the murmur—such as palpitations, shortness of breath, or chest discomfort—may be felt.

When should I see a doctor about heart murmur symptoms?

You should seek medical attention if you experience symptoms such as severe shortness of breath, chest pain, fainting spells, persistent irregular heartbeat, significant swelling in your legs or abdomen, or bluish discoloration of your skin. If you’ve been diagnosed with a heart murmur and notice new or worsening symptoms, contact your healthcare provider promptly.

Can exercise make a heart murmur worse?

For innocent murmurs, exercise is generally safe and beneficial. However, for abnormal murmurs, strenuous exercise may exacerbate symptoms or worsen the underlying condition. Always consult with your cardiologist about appropriate activity levels if you have a diagnosed heart murmur.

Are heart murmurs hereditary?

Some congenital heart defects that cause heart murmurs can run in families, suggesting a genetic component. However, many heart murmurs result from acquired conditions that aren’t directly inherited. If you have a family history of heart defects or valve disease, inform your doctor for appropriate screening.

Can stress cause heart murmurs?

Stress itself doesn’t directly cause heart murmurs, but it can increase blood flow and heart rate, which may make an existing innocent murmur more audible. Chronic stress can contribute to heart disease development, which might eventually lead to valve problems and abnormal murmurs.

References:

• Mayo Clinic – Heart Murmurs
• American Heart Association – What Is a Heart Murmur
• National Heart, Lung, and Blood Institute – Heart Murmurs
• Johns Hopkins Medicine – Heart Murmur
• Cleveland Clinic – Heart Murmur