a regular medical checkup, your doctor will use a stethoscope to listen to your
heartbeat to determine whether your heart is beating properly and has a normal
rhythm. This gives your doctor information concerning the health of your heart.
If your doctor hears a “murmur” or any other abnormal sounds coming from your
heart, it may be an early indicator of a serious heart condition.
Symptoms of Abnormal Heart
many cases, heart murmurs and other abnormal heart sounds can only be detected
when your doctor listens to your heart using a stethoscope. You may not notice
any outward signs or symptoms of a heart murmur or other abnormal heart sounds.
some cases, you may notice signs or symptoms of an underlying heart condition.
These may include:
- chest pain
- chronic cough
- shortness of
- dizziness or
- heavy sweating
with little exertion
- skin that looks
blue, especially on your lips or fingertips
- sudden weight
gain or swelling
- enlarged neck
- enlarged liver
What Are the Types of Heart
Murmurs and Other Abnormal Sounds?
normal heartbeat has two sounds, a lub (sometimes called S1) and a dub (S2).
These sounds are caused by the closing of valves inside your heart. If there
are problems in your heart, there may be additional or abnormal sounds.
most common abnormal heart sound is a heart murmur. A murmur is a blowing,
whooshing, or rasping sound that occurs during your heartbeat. There are two
kinds of heart murmurs: innocent (also called physiological) and abnormal.
innocent murmur is found in children. It’s caused by small holes between the
different chambers of the heart. Usually, this condition doesn’t cause
significant problems, but it may need to be monitored over time.
abnormal murmur in a child is due to congenital (present at birth) heart
malformations. It may need to be corrected with surgery.
abnormal murmur in adults is usually caused by problems with the valves that
separate the chambers of your heart. If a valve doesn’t close tightly and some
blood leaks backward, this is called regurgitation. If a valve has become too
narrow or becomes stiff, this is known as stenosis. It can also cause a murmur.
are graded depending on how loud the sound is. The scale for grading runs from
one to six, where one is very faint and six is very loud — so loud that it may
not need a stethoscope to be heard. Murmurs are also categorized as occurring
during either the first sound (S1), as systole murmurs, or during the second
sound (S2), as diastole murmurs.
heart sounds include a “galloping” rhythm, which involves additional heart
sounds, S3 and S4.
S3 gallop or “third heart sound” is a sound that occurs after the diastole S2
“dub” sound. In young athletes or pregnant women, it’s likely to be harmless.
In older adults, it may indicate heart disease.
S4 gallop is an extra sound before the S1 systole “lub” sound. It’s always a
sign of disease, likely the failure of the left ventricle of your heart.
can also have both an S3 and an S4 sound. This is called a “summation gallop,”
which can occur when your heart is beating very fast. A summation gallop is
or short, high-pitched sounds may also be heard during your regular heartbeat.
This could indicate a mitral valve prolapse, when one or both flaps of your
mitral valve are too long. This can cause some regurgitation of blood into your
sounds may be heard in people with certain kinds of infections. A rubbing sound
is usually caused by an infection in your pericardium (a sac that surrounds
your heart) due to a virus, bacteria, or fungus.
What Are the Causes of
Heart Murmurs and Other Sounds?
heart is made up of four chambers. The two upper chambers are called the atria,
and the two lower chambers are called the ventricles. Valves are located
between these chambers to make sure that your blood always flows in one
tricuspid valve goes from your right atrium to your right ventricle. The mitral
valve leads from your left atrium to your left ventricle. The pulmonary valve
goes from your right ventricle out to your pulmonary trunk, and the aortic
valve goes from your left ventricle to your aorta. Your pericardial sac
surrounds your heart and protects it.
with these parts of your heart may lead to unusual sounds that your doctor can
detect by listening to your heart with a stethoscope or by performing an
especially in children, may be caused by congenital (present at birth) heart
malformations. These can be benign and never cause symptoms, or they can be
severe malformations that require surgery or even a heart transplant. Innocent
murmurs include pulmonary flow murmurs, a Still’s murmur, and a venous hum.
of the more serious congenital problems that causes heart murmurs is called the
“Tetralogy of Fallot.” This is a set of four defects in the heart that lead to
episodes of cyanosis. Cyanosis happens when an infant or child’s skin turns
blue from lack of oxygen during activity, such as crying or feeding.
heart problem that causes a murmur is patent ductus arteriosus, in which a
connection between the aorta and the pulmonary artery fails to close correctly
after birth. Other congenital problems include atrial septal defect,
coarctation of the aorta, and ventricular septal defect.
Heart Valve Defects
adults, murmurs are usually the result of problems with heart valves. This may
be caused by an infection, such as infective endocarditis. Valve problems can
also simply occur as a part of your aging process, due to wear and tear on your
or backflow, happens when your valves don’t close properly. Your aortic valve
can have aortic regurgitation. Your mitral valve can have acute regurgitation
that is caused by a heart attack or a sudden infection. It can also have
chronic regurgitation that is caused by high blood pressure, infection, mitral
valve prolapse, or other causes.
tricuspid valve can also suffer from regurgitation, usually caused by the
enlargement (dilatation) of your right ventricle. Pulmonary regurgitation is
caused by the backflow of blood into your right ventricle when your pulmonary
valve can’t close completely.
is a narrowing or stiffening of your heart valves. Your heart has four valves
and each valve can have stenosis in a unique way:
- Mitral stenosis is
usually caused by rheumatic fever, a complication of untreated strep throat or
scarlet fever. Mitral stenosis can cause fluid to back up into your lungs,
causing pulmonary edema.
- Aortic stenosis
can also occur because of rheumatic fever, and it may cause heart failure.
stenosis can occur because of rheumatic fever or heart injury.
- Pulmonary valve
stenosis is usually a congenital problem and runs in families. Aortic and
tricuspid stenosis can also be congenital.
cause of heart murmurs is stenosis caused by hypertrophic cardiomyopathy. In
this condition, the muscle of your heart thickens, which makes it harder to
pump blood through your heart. This results in a heart murmur. This is a very
serious disease that’s often passed on through families.
Causes of Clicks
clicks are caused by problems with your mitral valve. Mitral valve prolapse is
the most common cause. It occurs when one or both flaps of your mitral valve
are too long. This can cause some regurgitation of blood into your left atrium.
Causes of Rubs
rubs are caused by friction between layers of your pericardium, a sac around your
heart. This is usually caused by an infection in your pericardium due to a
virus, bacteria, or fungus.
Causes of Galloping Rhythms
galloping rhythm in your heart, with a third or fourth heart sound, is very
rare. An S3 sound is likely caused by an increased amount of blood within your
ventricle. This may be harmless, but it can also indicate underlying heart
problems, such as congestive heart failure. An S4 sound is caused by blood
being forced into a stiff left ventricle. This is a sign of serious heart
How Are Heart Murmurs and
Other Sounds Evaluated?
doctor will listen to your heart with a stethoscope, a medical device used to
listen to your heart, lungs, and other organs in your body. If they detect
problems, your doctor may order an echocardiogram. This is a test that uses
sound waves to create a moving picture of your heart to help your doctor get a
better understanding of the abnormalities detected.
your doctor hears any abnormal heart sounds, they may ask you questions about
your family. If any of your family members have also had abnormal heart sounds
or a history of heart problems, it’s important to tell your doctor. It may make
diagnosing the cause of your abnormal heart sounds easier.
doctor will also ask if you’ve had any other symptoms of heart problems, such
as bluish skin, chest pain, fainting, distended neck veins, shortness of
breath, swelling, or weight gain. Your doctor may also listen to your lung sounds
and may also examine you to see if you have signs of liver enlargement. These
symptoms may provide clues about what type of heart problem you’re
What Can Be Expected in the
heart sounds often indicate some type of underlying heart disease. This may be
treated with medication, or it may require surgery. It’s important to follow up
with a heart specialist to learn the details of your condition.