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Baby Heart Murmurs: Causes, Symptoms, Diagnosis and Treatment

A heart murmur is an unusual sound made by the heart. It is usually the extra noise made by the blood while negotiating its way around the tight bends inside the child’s heart. Generally, when the paediatricians refer to heart murmurs in the baby, parents worry sick. But what could solace each parent is – most of the murmurs are normal and without any harm to the child. So, here is everything you need to know about heart murmurs in babies.

What is heart murmur?

A heart murmur is the abnormal swishing or whooshing sound made by blood moving through the heart. It is other than the lubb-dub sound made by the heart. Heart murmurs are heard by physicians using a stethoscope. Heart murmurs are very common in infants and children.

Causes of Heart Murmurs:

Heart murmurs are of two types:

1. Innocent murmurs:

It may also be called functional, physiologic or benign. The normal heart displays innocent murmur. It is common in newborns and children.

2. Abnormal murmurs or pathological heart murmur: 

It is usually caused by serious problems. In babies and children, it is usually caused by congenital heart disease such as cardiac shunt. In adults, it might be due to heart valve problems.

Symptoms of Heart Murmurs:

Symptoms of Heart murmurs differ with the causes. Innocent heart murmurs usually do not display any symptoms. The abnormal heart murmurs caused by abnormalities in the heart or congenital cardiovascular heart diseases may cause feeding problems or lack of normal growth in infants, dizziness, shortness of breath, fainting, chest pain, rapid heartbeats, fatigue with exertion or exercise, palpitations and lung congestion.

Diagnosis:

Heart murmurs are diagnosed by the physician using stethoscope during a newborn examination or regular physical exam. The physician listens to the heartbeat and evaluates several factors such as loudness, frequency, duration, timing, pitch and location of the murmur. The heart murmur is rated from 1 to 6 based on how loud they are. However, it is not precise as it is rated based on the physician’s judgment.

Loud heart murmurs are usually evaluated further. Infants with heart murmurs and do not feed or breath properly, and children who lose consciousness all of sudden should be evaluated. They are usually referred to a pediatric heart specialist, called the pediatric cardiologist. Cardiologists review personal and family history and perform the physical examination. The physical exam includes recording blood pressure, pulse, reflexes, and height and weight. Also, internal organs are palpated to check if they are enlarged.

In order to determine if the child has any conditions or heart disorders, the physician may refer a few tests such as chest x-ray, ultrasound of the heart (echocardiogram) – To see how the heart is formed and how well it is working), or electrocardiogram. The chest x-ray shows the size, shape, and location of heart and lungs.

Treatment:

Innocent murmurs appear and disappear on their own. It doesn’t need any follow-up or treatment.

If the heart murmur is caused by the septal defect, corrective surgery is required. For heart murmurs caused by heart valve disease, it could be treated either by medication or valve replacement or repair surgery. The pediatric cardiologist suggests the apt type and timing of treatment, based on child’s physical and overall health condition.

Nutritional concerns:

Nutritional supplements may be needed for babies with congenital cardiovascular defects. It is added to formula or breast milk. Sometimes additional feedings are required to help the baby gain weight. It is given by nasogastric tube. It is placed in the baby’s nose and passed into the stomach. Formula or breast milk is delivered through this tube to provide enough calories to the baby. 

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