HEART MURMURS: Why do I Experience Abnormal Heart Sounds?
INTRODUCTION TO HEART MURMURS AND ABNORMAL HEART SOUNDS
Heart murmurs and abnormal heart sounds are a bit of an issue. When a person goes for a medical checkup, the doctor will pay attention to his or her heartbeat with the aid of an instrument known as a stethoscope. With the stethoscope, the doctor can tell whether your heart is beating with the correct rhythm. If your doctor hears heart murmurs or other abnormal heart sounds, it may be an early symptom of a serious heart disorder.
SYMPTOMS OF ABNORMAL HEART SOUNDS
Abnormal heart sounds such as heart murmurs can only be detected with the aid of a stethoscope. As an individual, you may not notice any external symptoms or signs of a heart murmur or other abnormal heart sounds.
In many cases, you may experience the symptoms of an underlying cardiac condition. These symptoms include:
- Pains in the chest
- Chronic cough
- Dyspnea or shortness of breath
- Enlarged liver
- Fainting or dizziness
- Enlarged neck veins
- Swelling or sudden gain of weight
- A bluish tint to the skin
TYPES OF HEART MURMURS & ABNORMAL HEART SOUNDS
The heart makes two major sounds when it beats – a lub sound (also known as S1), and a dub sound (known as S2). Heart sounds result from the closing of the heart valves. If you have heart problems, you’ll have other abnormal or additional sounds.
Heart murmurs are the most common abnormal heart sounds. A heart murmur is a whooshing, rasping, or blowing sound that occurs when your heart is beating. We have two types of heart murmurs: the innocent heart murmur also referred to as physiological murmur and the abnormal murmur.
An innocent or physiological murmur occurs in children and adults. It happens when blood moves normally through the heart. In adults, a physiological murmur is caused by fever, pregnancy, or physical activity.
Children may suffer an abnormal murmur due to congenital heart malformations. Such malformations are corrected with surgery.
Adults experience abnormal murmur when they have problems with the valves that separate the heart chambers. If the valve fails to close tightly and blood leaks backward, the condition is known as regurgitation. If the valve narrows or stiffens, then it is known as stenosis. Stenosis can also cause a heart murmur.
Murmurs are classified depending on how loud the sound is. The grading scale ranges from 1 – 6 with one being very faint, and six being very loud. In some cases, loud murmurs can be heard even without a stethoscope. Murmurs are also classified as systole murmurs (S1), or diastole murmurs (S2).
Another type of heart sound is the “galloping” rhythm Galloping rhythm involves S3 and S4 sounds.
The S3 gallop occurs after the S2 dub sound. It is harmless in pregnant women or young athletes. However, if it happens in older adults, then it is an indication of heart disease.
An S4 gallop is an extra sound that comes before the S1 systole “lub” sound. It indicates a disease, mostly left ventricular failure.
A person may have both an S3 and an S4 sound. We call this a “summation gallop,” which can occur during tachycardia (fast heart rate). Summation gallops are rare.
OTHER ABNORMAL HEART SOUNDS
A regular heartbeat may also be characterized by short, high-pitched sounds or clicks. This may be a symptom of a mitral valve prolapse. It can cause your left atrium to regurgitate blood.
People who have some form of infection may experience rubbing sounds. A rubbing sound is often caused by a pericardial infection due to fungus, bacteria, or virus.
WHAT CAUSES HEART MURMURS?
The human heart has four chambers – the atria (upper chambers), and the ventricles (Lower chambers). Valves exist between both chambers. These valves ensure the unidirectional flow of blood.
The tricuspid valve crosses your right atrium into your right ventricles. On the other hand, your mitral valve leads from your left atrium into your left ventricle. Your pulmonary valve starts from your right ventricle to your pulmonary trunk, while your aortic valve leads from your left ventricle into your aorta. Your heart is surrounded and protected by your pericardial sac.
If these parts of your heart have any problems, they might lead to unusual sounds that may be detected with a stethoscope or an echocardiogram test.
Heart murmurs may also be caused by congenital malformations. Heart murmurs due to this cause occur mostly in children. They are benign and don’t cause symptoms, or they may be so severe that they’ll require a heart transplant or a surgery. Innocent heart murmurs include venous hum, Still’s murmur, and pulmonary flow murmurs.
A major congenital problem that triggers heart murmurs is known as the “Tetralogy of Fallot.” These are heart defects that lead to episodes of cyanosis. Cyanosis is a bluish tint on the skin of a child or an infant due to lack of oxygen during activity, such as feeding or crying.
Patent ductus is another cardiac problem that leads to a heart murmur. In patent ductus arteriosus, the link between the pulmonary artery and the aorta fails to close correctly after birth. Other examples of congenital problems include coarctation of the aorta, ventricular septal defect, and an atrial septal defect.
DEFECTS OF THE HEART VALVE
Heart murmurs in adults occur as a result of a malfunction of the heart valves. The usual cause may be an infection, like infective endocarditis. Problems with the heart valve may also be due to old age, due to the wear and tear on your heart.
Backflow, also known as regurgitation, occurs when your heart valves fail to close properly. Aortic regurgitation may also occur with the aortic valve. The mitral valve may have an acute regurgitation caused mostly by an acute infection or by a heart attack. The mitral valve is also prone to chronic regurgitation caused by infections, high blood pressure, prolapse of the mitral valve, among other causes.
The tricuspid valve is also prone to regurgitation. In this case, the cause is a dilatation (enlargement) of your right ventricle. Backflow of blood into your right ventricle results in pulmonary regurgitation. This happens when your pulmonary valve fails to close completely.
Stenosis is a term that defines the stiffening or narrowing of the heart valves. The human heart has four valves, with each being prone to stenosis is a characteristic way:
- Mitral stenosis due to complications from scarlet fever, strep throat, or rheumatic fever. A person who has mitral stenosis is also at risk for pulmonary edema.
- Aortic stenosis may also occur as a result of rheumatic fever, and it may lead to failure of the heart.
- Tricuspid stenosis can result from heart injury or rheumatic fever
- Stenosis of the pulmonary valve is a congenital disorder and is hereditary. Tricuspid and aortic stenosis may also occur as congenital disorders.
Hypertrophic cardiomyopathy is another cause of heart murmurs. In hypertrophic cardiomyopathy, muscles of the heart thicken. This makes it difficult for the heart to pump blood through the body. Of course, the result is a heart murmur. Hypertrophic cardiomyopathy is a serious condition with a hereditary undertone.
WHAT CAUSES CLICKS?
Heart clicks occur when the mitral valve malfunctions. The major cause is mitral valve prolapse. It occurs when one or both flaps of your mitral valve are too long. This results in regurgitation of blood into your left atrium.
WHAT CAUSES GALLOPING RHYTHMS?
A galloping rhythm is a rare disorder. It may occur with a third or fourth sound. A third sound is due to excess blood within your ventricle. This may not cause any harm, but it could also be an indication of an underlying heart disorder, like congestive heart failure. An S4 sound results from the forcing of blood into a stiff artery. This is an indication of a serious heart condition.
HEART RUBS – THE CAUSES
Heart rubs occur when both layers of your pericardium have friction. This is caused by a pericardial infection due to a fungus, bacteria, or a virus.
EVALUATING HEART MURMURS & OTHER ABNORMAL HEART SOUNDS
Your doctor will pay close attention to your heartbeat with a stethoscope. If he or she suspects any problem, they will order an echocardiogram. An echocardiogram is a test that uses sound waves to create a moving picture of your heart. With this, your doctor will have a perfect understanding of any detected abnormality.
If any abnormal heart sounds are detected by your doctor, he or she will ask you questions about your family. The aim is to know whether there is a history of heart conditions in your family. You should give your doctor honest answers so that he or she will be able to make a correct diagnosis, and draw an effective plan of treatment.
Your doctor will also ask about any symptoms you may have experienced, such as pains in the chest, bluish skin, shortness of breath, distended neck veins, or weight gain. He or she will also pay attention to the sounds made by your lungs. Examinations will also be done to know whether you’ve got any liver enlargement. These symptoms will provide a clue as to the type of heart problem that you have.
Heart murmurs and other abnormal heart sounds are an indication of an underlying heart condition. Treatment may be by medications or surgery. You should follow up with a cardiologist to know the details of your heart condition
Tonika Bruce, MSN, RN, MBA. is an accomplished nurse leader, published author, and personal development expert passionate about advancing healthcare management and quality patient outcomes.
She taps into the years of experience in healthcare management to produce credible and easy-to-understand health and leadership content. Her exceptional work has been featured in reputable publications, including Forbes, Recruiter, Inc, and the Color of Wellness magazine.