Heart Murmurs in Children: When They’re Harmless and When They’re Not
Being told that you or your child has a heart murmur can sound frightening, but a murmur is not always a sign of heart disease. In many people, especially children, a murmur is harmless and simply reflects normal blood flow through a healthy heart. In other cases, it may be a clue that the heart valves, heart muscle or heart structure need further assessment. The most important thing is to understand what a murmur means, which symptoms matter and when a check-up is needed.
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What is a heart murmur?
An extra sound heard through a stethoscope
A heart murmur is an extra sound heard during a heartbeat. Instead of the usual “lub-dub” sound, a doctor may hear a whooshing, swishing or blowing sound. This sound is caused by blood moving in a more turbulent way through or near the heart. A murmur is not something most people can feel, and many are only discovered during a routine check-up.
A murmur is a sign, not a diagnosis
The word “murmur” describes a sound, not a specific disease. Some murmurs happen in completely healthy hearts, while others are linked to a heart valve problem, a hole in the heart, an infection, anaemia, fever or other medical conditions. This is why a doctor will consider the person’s age, symptoms, medical history and the sound of the murmur before deciding whether any tests are needed.
When a murmur may be harmless
Innocent murmurs are common
Harmless murmurs are often called innocent, functional or flow murmurs. They can happen when blood flows faster than usual through a normal heart. This may occur during childhood, pregnancy, fever, exercise, anxiety or anaemia. Innocent murmurs do not usually cause symptoms and do not mean the heart is damaged.
Many children outgrow them
Innocent murmurs are especially common in children. They may come and go, become easier to hear when a child has a fever or is excited, and disappear as the child grows. If a doctor is confident that the murmur is innocent and the child is otherwise healthy, no treatment may be needed. Children with innocent murmurs can usually play, exercise and live normally unless a doctor advises otherwise.
When a murmur may need further investigation
Some murmurs are linked to heart problems
An abnormal murmur may be caused by a structural heart issue or a valve that is narrowed, leaking or not opening and closing properly. Some causes are present from birth, while others develop later in life. In adults, murmurs may sometimes be linked to valve disease, previous infections, ageing-related valve changes or other heart conditions. Not every abnormal murmur is immediately dangerous, but it should be properly assessed.
Symptoms make the murmur more concerning
A murmur is more likely to need attention if it is accompanied by symptoms such as shortness of breath, chest pain, fainting, dizziness, palpitations, tiredness that is unusual for the person, swelling of the legs or bluish lips or skin. In babies, warning signs may include poor feeding, sweating during feeds, breathing fast, poor weight gain or turning blue. These symptoms should never be ignored.
Heart murmurs in children
Most are not dangerous, but babies need careful assessment
Many children have innocent murmurs at some point, and this can be very reassuring for parents. However, murmurs in newborns and young babies need careful assessment because a small number can be linked to congenital heart problems. A doctor will listen to the heart, check breathing, feeding, growth and oxygen levels, and decide whether a referral or echocardiogram is needed. Parents should always mention any feeding difficulties, sweating, blue colour, poor growth or unusual tiredness.
A murmur does not automatically mean restricted activity
Parents often worry that a child with a murmur should not run, play sport or be active. If the murmur is innocent, children are generally encouraged to stay active and enjoy normal play. Activity restrictions are only needed if a doctor identifies a heart condition that requires them. If a child becomes breathless, faints, has chest pain during exercise or cannot keep up with peers, they should be medically reviewed.
Heart murmurs in adults
A new murmur should be checked
In adults, a newly detected murmur may still be harmless, but it is important to consider whether there are symptoms or risk factors. Doctors may ask about breathlessness, chest discomfort, fainting, palpitations, previous rheumatic fever, heart infections, high blood pressure or a family history of heart disease. Some valve problems progress slowly, so early assessment can help identify issues before they become more serious. If a murmur has been present for years and previously investigated, the doctor may simply monitor for changes.
Pregnancy and illness can change blood flow
During pregnancy, the body pumps more blood, and this can sometimes produce a flow murmur in an otherwise healthy heart. Fever, anaemia and thyroid problems can also affect blood flow and make a murmur easier to hear. The underlying cause matters, so doctors look at the whole person rather than the murmur alone. Treating anaemia, infection or another medical condition may reduce a flow-related murmur.
How doctors check a heart murmur
The stethoscope gives important clues
A doctor listens to where the murmur is loudest, when it occurs during the heartbeat, how loud it is, whether it changes with position and whether there are other signs on examination. Blood pressure, pulse, oxygen levels, breathing and signs of swelling may also be checked. These details help the doctor decide whether the murmur sounds innocent or whether further tests are needed.
An echocardiogram may be recommended
An echocardiogram is an ultrasound scan of the heart. It shows the heart’s chambers, valves and pumping function, and it can help diagnose valve disease, congenital heart problems and other structural issues. Other tests, such as an ECG, chest X-ray or blood tests, may be used depending on the symptoms and clinical picture. The goal is not to alarm the patient, but to understand the cause clearly and guide treatment if needed.
When to seek medical help
Reassurance is helpful, but assessment is important
If you have been told you have a heart murmur, it is reasonable to ask what type it is, whether it needs follow-up and what symptoms to watch for. Many murmurs are harmless, but a proper check-up gives peace of mind and helps identify the few that need closer attention. Do not panic, but do not ignore new symptoms either. A GP can listen, assess your risk and refer you if further cardiac testing is needed.
At Midrand Medical Centre, our doctors can assess heart murmurs, discuss your symptoms and guide you on whether further testing or referral is necessary. If you are worried about a murmur in yourself or your child, we are here to help you take the next step calmly and confidently.
☎️ 011 315 2512
📧 info@midrandmedicalcentre.co.za
📌 The Emporium, Corner Church & Market Streets, Midrand
Sources
- British Heart Foundation – Heart Murmurs
- American Heart Association – Heart Murmurs
- Mayo Clinic – Heart Murmurs: Symptoms and Causes
- Cleveland Clinic – Heart Murmur
- NHS – Echocardiogram
- American Academy of Family Physicians – Heart Murmurs in Children: Evaluation and Management
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