A heart murmur or ‘heart murmur’ is the sound of swirling blood in the heart. It can be heard with a stethoscope, a doctor’s aid to amplify sounds in the body. Usually, a heart murmur is harmless. It arises in the heart or in the large blood vessels without a congenital heart defect. Sometimes a heart murmur does indicate a congenital heart defect.
A heart murmur is common. A murmur can be heard in about half of the children of nursery and primary school age. Fortunately, a congenital heart defect occurs in only eight out of a thousand children. Children with a syndrome, for example, Down’s syndrome, and children with another birth defect are more likely to have a congenital heart defect.
See also, Heart and vascular disease
How do you recognize a heart murmur?
You cannot hear a heart murmur yourself, usually it is discovered by the GP or the consultation doctor. With an innocent murmur, there is nothing wrong with your child’s heart and therefore there is no effect on the health of your child.
If a congenital heart defect is the cause of the murmur, you may notice something about your child, especially if it is an infant or a toddler. Most, sometimes even serious heart defects do not cause any complaints.
Complaints to an infant
- drinking badly
- grow poorly
- heavy sweating when drinking or crying
- shortness of breath at rest or with light exertion
- blue discoloration of the lips and tongue
However, these characteristics may very well have another cause.
Complaints with a toddler A complaint, which can be caused by a congenital heart defect, is less able to sustain physical exertion than peers. However, this characteristic may very well have another cause.
How does a heart murmur occur?
There are many different causes for a heart murmur. Usually the cause is harmless. The heart murmur then arises because your child’s heart pumps the blood around quickly and vigorously. A non-harmless heart murmur is caused by an abnormality in the heart. Often during pregnancy, a part of the heart is not completely laid out. This could be a hole in the wall between chimneys or rooms or a defect on a valve. Occasionally a heart murmur is caused by a much more complicated abnormality where oxygenated and oxygenated blood mix, causing the child to turn blue
Is it serious and what can you expect?
A heart murmur is usually harmless, sometimes it indicates a heart defect. It is therefore important that someone listens to the murmur who has a lot of experience with it. An innocent murmur sounds different from a non-innocent murmur. Sometimes, however, it is difficult to distinguish. If your doctor or consultation doctor is unsure whether it is an innocent murmur or not, he / she will be on the safe side and refer your child to the hospital. In the hospital, the pediatrician or pediatric cardiologist will examine your child and also listen to the heart. You will also be asked how your child is developing and whether it has the characteristics under the heading ‘How do you recognize it?’ being described. Often an ultrasound of the heart is also made.
An innocent heart murmurs If the heart murmur is harmless, no further treatment or monitoring is required. As your child gets older, the heart enlarges, causing the blood to circulate at a calmer pace and the heart murmur disappears. The noise has disappeared in 80 percent of the children when they have reached the age of twenty.
If there is an abnormality that places little burden on the heart If the heart appears not to be affected by the abnormality, your child will be controlled and usually, no treatment is required. Also If it is a hole in the wall between the rooms, this may even close automatically.
If there is an abnormality that does burden the heart If the heart seems to be bothered by the abnormality, the abnormality can often be repaired with surgery. If you find yourself in this situation, ask the pediatric cardiologist for an explanation.
Preventive antibiotics For all heart defects, there is a risk that bacteria will attach to the abnormal part of the heart. This can only happen if bacteria get into the blood. The chance of this exists mainly in operations and the extraction of teeth. Children with a heart defect should therefore take a high dose of antibiotics an hour before such an operation to prevent such an infection. General practitioner, dentist and surgeon are aware of this.
Children with an innocent heart murmur have no deviation and this does not apply to them.
When to the doctor?
It is advisable to see your doctor if your baby or toddler has the characteristics mentioned under ‘How do you recognize a heart murmur?’.
What can you do about it yourself?
You cannot do anything about a heart murmur.
General advice and precautions
If there are heart defects in children or adults at an early age in the family, report this to the consultation center or the doctor. It can then be taken into account. It can be a reason to forward your child faster if there is a murmur. This also applies if your child has a syndrome, including Down’s syndrome or other birth defects.
Source : Drs. JH Schieving (author) Dr. MTE Bink-Boelkens (consultant)
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