A cardiology professor at Virginia Commonwealth University School of Medicine notes that a heart murmur can sometimes signal a valve issue, even though not every murmur is dangerous. In many cases these sounds come from normal activity within the heart and vessels, but they can also point to underlying problems. A heart murmur is an audible byproduct of blood flow changes and is often detected when a clinician listens to the chest with a stethoscope. Some murmurs are simply a normal variation in how an individual’s heart functions and require no treatment, while others raise concern about heart valve performance.
The hum or whoosh heard during a heartbeat is created as the heart valves close. Blood moves from the atria into the ventricles, then onward to the arteries. Healthy valves snap shut in a precise sequence to prevent any backward leakage of blood. When a valve does not seal tightly enough, a portion of the blood can slip backward into the chamber it just left, creating an audible murmur. This backflow is not always a sign of trouble, but it can be a signal that further evaluation is needed to rule out valve disease.
Murmurs can arise from several scenarios. Some are linked to structural issues with the heart valves themselves, while others are caused by infections that affect the heart, congenital abnormalities present from birth, or inflammatory processes that alter valve function. Infections of the inner lining of the heart or the valves, known as endocarditis, can produce murmurs, as can rheumatic conditions that alter the heart’s architecture. A clinician will differentiate these causes through a detailed history, a physical exam, and targeted tests.
There are murmurs that occur without heart disease or valve problems. These are often labeled as physiological murmurs and are more common in younger people, including children and teenagers. During periods of rapid growth, such as a growth spurt, blood flow must increase to meet the body’s changing demands. This heightened flow can generate sounds beyond the usual heartbeat. In many cases, these murmurs disappear with time as the heart and circulatory system mature.
For anyone who detects or is told about a murmur, it is important to seek medical guidance. A clinician will typically perform a physical examination and may order tests to determine the cause and significance of the murmur. Depending on findings, additional imaging like an echocardiogram, which uses ultrasound to visualize heart valves and chambers, can clarify whether a valve is leaking, narrowing, or functioning normally. In some cases, monitoring over a period of weeks or months is enough, while in others, a more comprehensive evaluation is warranted to identify a potential risk that could require treatment.
Understanding murmurs also involves recognizing accompanying symptoms. Shortness of breath, chest pain, fainting spells, swelling in the legs or abdomen, or unusual fatigue can accompany valve problems and guide a clinician toward a diagnosis. Risk factors such as a history of rheumatic fever, congenital heart defects, high blood pressure, and a family history of heart disease may influence the likelihood of valve-related murmurs and prompt earlier testing.
Advances in cardiac imaging and research continue to refine how doctors assess murmurs. Even when a murmur is benign, tracking its presence and understanding the patient’s overall heart health remain essential. The goal is to distinguish harmless sounds from those that herald a valve problem or another cardiovascular condition, ensuring timely care when needed. Ongoing studies also explore links between heart valve function and broader health outcomes, including cognitive health in older adults, underscoring the interconnected nature of cardiovascular status and overall well-being.