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Heart Murmurs – Common Symptom of Childhood Heart Issues

Posted 1/13/2017 by UHBlog

If your child is chronically lethargic or lacks an appetite, he could have an underlying heart issue. We can help.

Symptoms of Heart Problems in Children

Learning your child has a heart murmur shouldn’t automatically strike fear in your own heart.

“Everybody’s heart has certain sounds we hear when we listen through a stethoscope,” says pediatric cardiologist Sarah Plummer, MD. “Murmurs are additional sounds. The majority of children will have a heart murmur at some point during normal growth and development.”

Pediatricians are trained to distinguish innocent murmurs – meaning those that are harmless – from murmurs that require further evaluation. Children with heart murmurs are referred to a pediatric cardiologist if:

  • The murmur is loud
  • The timing of the murmur is off in relation to other sounds heard through a stethoscope
  • A physical exam reveals additional abnormalities
  • The child has symptoms that may be related to the heart

Infants with heart murmurs may need additional testing if they aren’t feeding well, aren’t gaining weight or are lethargic. Older children with heart murmurs who have difficulty exercising may also require further examination.

According to Dr. Plummer, most children who are referred to a pediatric cardiologist will undergo an electrocardiogram (EKG), which is a heart rhythm tracing that also provides the doctor with information about the size of the heart’s chambers. The EKG can indicate whether the child requires additional testing. If so, the next step is an echocardiogram (or heart ultrasound).

“This is the definitive test,” Dr. Plummer says. “It takes actual pictures of the structure of the heart and looks at its function, which is how well it’s squeezing.”

Less than 1 percent of heart murmurs are pathological, meaning they are caused by structural problems in the heart. But it’s important to detect – and, if necessary, treat – these problems early so they don’t cause additional health issues. Pathological concerns include:

  • Holes in the heart, which can occur between the top chambers or bottom chambers of the heart
  • Tight heart valves
  • Leaky heart valves

Depending on the size of the hole or which valve is leaking or too tight, doctors may be able to fix the problem with an intervention in the catheter lab or through open-heart surgery. Small holes may close on their own.

“It’s relatively rare to find something that requires emergency intervention,” Dr. Plummer says. “Generally we can diagnose an issue and follow the problem over time and see what needs to be done.”

Innocent heart murmurs, which change as the child matures, are often heard in newborns, school-age children and some teenagers. Most youngsters outgrow murmurs as the heart grows and the chest wall thickens, making innocent murmurs more difficult to hear through a stethoscope.

Whatever a child’s age, Dr. Plummer cautions parents not to overreact if their child’s pediatrician detects a heart murmur.

“A murmur doesn’t automatically mean there’s something wrong with the heart,” she says. “If there are concerns about anything other than an innocent heart murmur, pediatric cardiologists are happy to evaluate the child. Just by listening to the heart we can often put parents’ concerns to rest.”

Sarah Plummer, MD is a pediatric cardiologist at University Hospitals Rainbow Babies & Children’s Hospital. You can request an appointment with Dr. Plummer or any other doctor online.

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