Hearing from your doctor that your child has a pediatric heart murmur might be unsettling. Fortunately, the majority of kid cardiac murmurs are benign or unimportant. There are different kinds of heart murmurs, but the murmur itself is not the issue; it is merely a test finding based on an underlying condition. 5 to 50 cases of congenital heart disease (CHD) are reported for every 1000 live births. According to one study, there were 75 cases for every 1000 live births, and 6 of those were moderate or severe, or 6 cases for every million live births.
the contents table
What Exactly Is a Heart Murmur?
How are Heart Murmurs Rated?
-I’m Concerned About a Heart Murmur
Is My Child Suffering From Congenital Heart Disease (CHD)?
What Kinds of Congenital Heart Defects, or CHD, Lead to Pediatric Murmurs?
“Now What?”
A heart murmur is what?
Simply put, a heart murmur is the sound that your blood makes as it flows through your heart. The only sound you hear when listening to the heart is the valves closing because blood flow through the heart usually occurs quietly, smoothly, and calmly.
The change in a river as an illustration of blood flow
Normal blood flow is likened to the motionless, noiseless flow of a river in front of you. There is a lot of turbulence and commotion as the river approaches the rapids or rocks. In the heart, it is comparable. A heart murmur is noise, which is turbulent motion. Turbulence can be brought on by holes between the chambers, large or thin heart muscles, unusual blood channel paths, or flaws in the chambers’ architecture. There are two main categories of murmurs: pathogenic and innocent or benign. All pathologic murmurs are not immediately fatal.
How are heart murmurs classified?
The loudness of heart murmurs is rated on a scale of 1 to 6, with 6 being the loudest. It matters where and when they happen during the heartbeat. Systole, which occurs when the heart squeezes blood out to your body’s systems, results in systolic murmurs. Diastolic murmurs also happen as your heart relaxes and receives the subsequent blood flow. If a click is audible, its timing will affect the murmur.
I Am Concerned About a Heart Murmur
First of all, try not to worry because two-thirds of all children of preschool age may have benign cardiac murmurs. Fever, sickness, and excessive activity can amplify a quiet murmur. Positioning can affect a murmur’s ability to be detected. A child should be examined if they have a murmur between the ages of 0 and 6 months, have trouble feeding, growing, or gaining weight, or complain of chest pain when exerting themselves or shortness of breath.
The 7 S’s: Seven Characteristics of Innocent Heart Murmurs
-Short time frame
-One and no clicks
-Small, just covering a small portion of the exam
- Soft music
-Sweet sounding, not harsh
Systolic refers only to the contraction period of the heartbeat.
-Sensitive to heartbeat and breathing
Do I Need to Refer My Child to a Cardiologist?
Because harmless kid heart murmurs are so frequent, your doctor may feel extremely confident in making the diagnosis. They may consult a cardiologist if they are unsure. Your child can be properly diagnosed by a pediatric cardiologist. Murmurs that are innocent do not require additional analysis. Alternately, they may decide to perform some testing to better understand the condition of your child’s heart. These tests might include an EKG, which is an electrical recording of the heart’s activity, a chest x-ray that shows the heart’s silhouette, or an echocardiogram, which is an ultrasound of the heart that shows the organ’s chamber and valve structures and the order in which they function.
Is Congenital Heart Disease (CHD) present in my child?
Your child is unlikely to have major congenital heart problems if they have a heart murmur and are otherwise healthy. Between 4 to 50 cases of CHD are diagnosed for every 1000 live births, and 6 of those cases are moderate or severe. As a result, there are roughly 6 moderate or severe instances for every million live births.
What Kinds of Congenital Heart Defects, or CHDs, Lead to Pediatric Murmurs?
Congenital heart abnormalities can in a variety of forms, such as holes or septal defects that develop between the inner walls of the heart chambers, such as an atrial septal defect (ASD) between the two atrial chambers above. Between the two lower ventricular chambers, there is a ventricular septal defect (VSD). If the holes are not too large, they frequently seal themselves over time. Significant flaws could lead to more issues.
Valvular defects can be the cause of pediatric heart murmurs. Let’s start with some basic heart anatomy. The heart has four chambers, which translates to four valves. All blood returning to the heart from the body passes through the right upper chamber, often known as the right atrium. This discharges into the right ventricle via the tricuspid valve, which in turn discharges into the lung circulation via the pulmonary valve. After returning to the left atrium, the blood descends into the left ventricle through the mitral valve. The aortic valve then pumps blood out to your body.
Stenosis and regurgitation of the valves
A valve that is stenotic, such as the aortic valve, is stiff or deformed and may not fully open. Regurgitation, such as mitral regurgitation, occurs when a valve leaks backwards as a result of inadequate closure. The valve often contains too much tissue in cases of mitral regurgitation. As a result, there is a murmur and a click, but the atrial chamber must work harder to pump the blood once more. Every valve could have a different set of symptoms and diagnostic results. There could be abnormal valve structure. Aortic valves normally have three leaflets; however, some persons have bicuspid aortic valves, which only have two. Typically, there are no issues brought on by this.
Cardiomyopathies
Murmurs can result from cardiomyopathies, or diseases of the heart muscle. Just below the aortic valve, the heart muscle swells as a result of hypertrophic cardiomyopathy (HCM). Chest pain, dizziness, and even abrupt death can be brought on by HCM. Physicals for sports frequently find HCM. Tetralogy of Fallot, total anomalous pulmonary venous return (TAPVR), tricuspid atresia, transposition of the major vessels, and truncus arteriolis are a few severe congenital diseases. These types of cyanotic congenital heart abnormalities, which give the skin a blue color, are typically discovered soon after delivery. Similar to a ventricular septal defect, children with trisomy 21 or Down’s syndrome can also have an endocardial cushion defect. Children with Down syndrome frequently undergo screening.
Next, what?
Then inhale deeply. To fully comprehend everything your doctor is telling you about your child, be sure to ask lots of questions. For your personal piece of mind, find out the severity of the heart murmur. Your doctor will ask you direct questions in an open and honest manner.
A Real-Life Example
Many years ago, I informed a young mother that her child had a cardiac murmur. I provided a great deal of information regarding murmurs, what they might indicate, and their most likely causes. When she departed, I believed that I was being understood and that I was being straightforward. Her husband surprised me when he called the office thirty minutes later, apologizing for upsetting his wife so much. After I explicitly stated what I had said to his wife, he felt better. As I recall, the subsequent echocardiography was normal. We continued to get along well with that family for many years after that. She became alarmed at the notion of a murmur and stopped paying attention to everything else I said.
Hearing that your child has a heart murmur might be frightening. Fortunately, murmurs are very common and the majority are innocent.