How Is a Heart Murmur Diagnosed?
Doctors use a stethoscope to listen to heart sounds
and hear heart murmurs. They often notice innocent heart murmurs during routine
checkups or physical exams.
Doctors also may find abnormal heart murmurs during
routine checkups. When a
congenital
heart defect causes a murmur, its often heard at birth or during
infancy. Abnormal murmurs caused by other heart problems can be heard in
patients of any age.
Specialists Involved
Doctors usually refer people who have abnormal
murmurs to cardiologists or pediatric cardiologists for further care and
testing.
Cardiologists are doctors who treat adults who have
heart problems. Pediatric cardiologists treat children who have heart problems.
Physical Exam
Your doctor will carefully listen to your heart or
your childs heart with a stethoscope to find out whether a murmur is
innocent or abnormal. He or she will listen to the loudness, location, and
timing of the murmur to classify and describe the sound. This will help your
doctor diagnose the cause of the murmur.
Your doctor also may:
- Ask about your medical and family histories.
- Do a complete physical exam. He or she will look
for signs of illness or physical problems. These may include blue coloring of
the skin and delayed growth and feeding problems (in infants).
- Ask about your symptoms, such as chest pain,
shortness of breath (especially with physical activity), dizziness, or
fainting.
Evaluating Heart Murmurs
When evaluating a heart murmur, your doctor pays
attention to many things, such as:
- How faint or loud the sound is. Your doctor will
grade the murmur on a scale of 1 to 6 (1 is very faint and 6 is very
loud).
- When the sound occurs in the cycle of the
heartbeat.
- Exactly where the sound is heard in the chest and
whether it also can be heard in the neck or back.
- Whether the sound has a high, medium, or low
pitch.
- How long the sound lasts.
- How breathing, physical activity, or change of
body position affects the sound.
Classifying Heart Murmurs
Doctors classify murmurs as systolic, diastolic, or
continuous.
A systolic murmur is heard when the heart is
squeezing and pumping blood out of the heart.
A diastolic murmur is heard when the heart is
relaxing and filling with blood. Diastolic murmurs often are a sign of a heart
defect or heart disease, and further checking is likely needed.
A continuous murmur is heard during the entire
heartbeat. These murmurs often are a sign of a heart defect or heart disease,
and further checking is likely needed.
Diagnostic Tests and Procedures
If your doctor suspects you or your child has an
abnormal heart murmur, he or she may order one or more of the following tests.
Chest X Ray
A
chest
x ray is a painless test that creates pictures of the structures inside
your chest, such as your heart and lungs. This test is done to find the cause
of symptoms, such as shortness of breath and chest pain.
EKG
An
EKG
(electrocardiogram) is a simple test that detects and records the electrical
activity of the heart. An EKG shows how fast the heart is beating, the
hearts rhythm (steady or irregular), and where in the body the heartbeat
is being recorded.
An EKG also records the strength and timing of
electrical signals as they pass through each part of the heart.
This test is used to detect and locate the source of
heart problems. The results from an EKG also may be used to rule out certain
heart problems.
Echocardiography
Echocardiography
(EK-o-kar-de-OG-ra-fee) is a painless test that uses sound waves to create
pictures of your heart. The test gives information about the size and shape of
your heart and how well your hearts chambers and valves are working.
The test also can find areas of heart muscle that
arent contracting normally due to poor blood flow or injury from a
previous
heart
attack.
There are several different types of
echocardiography, including stress echocardiography. This type is done both
before and after a cardiac stress test. During this test, you exercise or take
medicine (given by your doctor) to make your heart work hard and beat fast.
Stress echocardiography shows whether you have decreased blood flow to your
heart (a sign of
coronary
artery disease).
Cardiac Catheterization
If your doctor thinks that your or your childs
abnormal heart murmur is due to a heart problem, such as a congenital heart
defect, he or she may want you to have a procedure called
cardiac
catheterization (KATH-e-ter-i-ZA-shun).
For this procedure, a long, thin, flexible tube
called a catheter is put into a blood vessel in your arm, upper thigh (groin),
or neck and threaded to your heart. Through the catheter, your doctor can
perform diagnostic tests and treatments on your heart. |