How to Cope with a Heart Murmur

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1Part 1: Adjusting Your Diet and Lifestyle

2Part 2: Taking Medication

3Part 3: Getting a Diagnosis

4Part 4: Recognizing the Symptoms

5Part 5: Identifying the Two Types of Heart Murmurs

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A normal, working heart beats at around 100,000 beats each day. Using a stethoscope, your doctor should hear a steady “lub-Dub...lub-Dub” from your heart. A heart murmur refers to abnormal heart sounds that are heard along with a normal heartbeat, such as a faint or loud swishing sound. Heart murmurs are classified into two types: innocent or “harmless” and abnormal. Innocent heart murmurs are not considered serious medical issues, but abnormal heart murmurs must be addressed, treated, and monitored.

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Method 1

Method 1 of 5:

Part 1: Adjusting Your Diet and Lifestyle

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   Stay away from foods with saturated fatty acids. This means avoiding processed food, fried food, fast food, red meat with fat residue, sausage and bacon, French fries, butter and whole dairy products.

   • These are all sources of harmful fats that can lead to unhealthy weight gain, a decrease in the velocity of your blood circulation, and an increase in the risk of developing other serious diseases such as atherosclerosis, diabetes mellitus, hypertension, heart failure and stroke.
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   Substitute fatty foods for food rich in omega 3 fatty acids and unsaturated fatty acids. This means cooking with vegetable oils like sesame and olive oils and eating more raw nuts and flaxseed.

   • Rather than reach for the standard loaf of white bread or bag of white rice, go for whole grain products such as barley and oatmeal, which are rich in vitamins, omega 3 acids and fibers. This will help to maintain your blood pressure and cholesterol levels, along with your sugar levels as these foods don’t contain white flour or a high carbohydrate index.
   • Whole grains such as brown rice or whole wheat pasta are good substitutes and you can include whole wheat flour in desserts such as muffins or pies.
   • Replace fatty meat with seafood and lean meat, and replace whole milk or dairy products with skimmed dairy products.
   • You can also increase your protein intake by eating other, healthier protein sources such as legumes, beans and peas.
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   Eat a lot of vegetable and fruits. They are excellent sources of vitamins, minerals, and natural anti oxidants that will boost your immune system and your overall health. They will also provide adequate amounts of different vitamins such as A, B, D, E, or C, along with calcium, iron, magnesium and other minerals that will help to form healthy red blood cells. This diet will help to improve any anemia problems, and keep your vascular system in a good health to avoid any blood pressure problems.

   • Eating fruits and vegetables will also help you maintain your blood pressure, sugar and cholesterol within normal levels and reap the benefits of the low fats and calories and high fiber content found in these foods, thereby preventing the development of any other cardiac disorders.
   • Avoid canned fruits and fruits preserved in sugary syrup as they contain high levels of sugar.
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   Limit the amount of sodium in your diet. Too much sodium can lead to hypertension or other related health problems like renal, cardiac disorders, or high cholesterol. Be aware of hidden sources of salt and avoid them, such as canned, processed food, and soy sauce.
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   Eat several small meals throughout the day, rather than two large meals. This will increase your metabolism and help you maintain a healthy weight.

   • Try not to have a meal right before bedtime, or two to three hours before you go to sleep. Eating right before sleeping will cause all the fats consumed to sit in your body and not be burned or metabolized, as you are not doing any activities to burn or get rid of them. This will also lead to an increase in your weight, blood, cholesterol and sugar levels to possibly dangerous levels.
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   Avoid smoking or drinking alcohol. These unhealthy habits can have a negative effect on your vascular system and narrow the lumen of your arteries. This will then elevate your blood pressure and put more pressure on your heart to pump and circulate blood efficiently.
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   Create a daily exercise program and commit to it. Performing exercise consistently will decrease your body weight, expel any stress or exhaustion and help to clarify your mind and refresh your body. Regular exercise will also help to regulate your blood pressure levels, and will return them to normal levels. Exercise will also regulate your sugar and cholesterol levels, which also helps to keep your vascular system and your heart healthy.

   • Start with light training such as aerobics and stick to a program you can perform three times a week. Gradually increase this exercise program so that eventually you are exercising every day. Other activities like walking, jogging, cycling, dancing or swimming will also benefit your health.
   • You can also join a recreational basketball or volleyball team or take up tennis or squash. Yoga is a great way to improve your heart rate and overall health. It is also accessible to all ages and levels of health, with poses you can learn easily on your own, or in a class with the supervision of a yoga instructor.
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   Go for regular heart check ups. Your doctor should continue to check your heart’s rhythm and sounds and evaluate your medical condition along with your lifestyle changes as well as any medication you are taking for your condition to note any improvements or shifts in your body. They should also monitor your blood, sugar and cholesterol levels.

   • Record your daily blood pressure readings in a log or journal to track your progress or any changes. Ask your doctor to look at them to ensure that they are within a normal range.
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Method 2

Method 2 of 5:

Part 2: Taking Medication

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   If you have an innocent murmur, create a therapy plan for other possible medical conditions. In general, doctors do not recommend treatment for heart murmurs as they are not considered an actual disease. Innocent murmurs do not require medical treatment at all as they will not affect or interfere with your daily routine. Instead, your doctor will focus on a therapy for any other medical conditions that may provoke your murmurs, such as rheumatic fever, anemia or hyperthyroidism.
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   If you have an abnormal murmur, ask your doctor about cardiac stimulants. Depending on the severity, grade, and location of your murmurs, and the type of heart defect you have (congenital or acquired), your doctor may prescribe a cardiac stimulant like Lanoxin (Digoxin). This medication is available as tablets or injections.

   • Lanoxin stimulates the contraction of your heart by increasing the intracellular levels of calcium. This will help your heart to pump more blood to correct its rhythm, especially if you have a weakened heart muscle.
   • Lanoxin is usually taken once daily with a doctor’s prescription.
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   Take anti-coagulants to avoid any risks of blood clots. Blood clots can form in blood circulation to your heart or around the valves of your heart. They are usually caused by a decrease in the blood’s velocity and may cause a stroke or heart attack.

   • Examples of anti-coagulants include Coumadin 2 or 5 mg (Warfarin), Aspirin (Acetyl salicylic acid) or Plavix (Clopidogrel).
   • Plavix is given only once daily while Coumadin can be given twice daily.
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   Get rid of excessive water in your body by taking diuretics. Excessive water can worsen your condition and even trigger other disorders such as hypertension or renal disorders.

   • Aldactone 25 or 100 mg (Spironolactone) is a widely used potassium sparing diuretic with the ability to expel excess water and sodium from the body without affecting your potassium levels. Aldactone also blocks aldosterone; which is a hormone secreted due to hypertension and a need to retain more sodium and water.
   • Aldactone is given only once daily in the morning.
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   Take drugs to reduce hypertension. Vasodilators such as Isoptin 80 mg or Verapamil 240 mg will do this. These drugs relax and dilate the peripheral vessels to reduce the peripheral resistance. They will also help the heart exert less stress while pumping.

   • Calcium channel blockers such as Norvasc 5 or 10 mg (Amlodipine) are used to reduce the intracellular calcium levels. This will relax the arterial smooth muscles and reduce your blood pressure.
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   Decrease your blood pressure with antiarrhythmic drugs. Cordarone (Amiodarone) can be taken once daily to control your heart rhythm and ventricular arrhythmia. It reduces the peripheral resistance and slightly increases the heart’s cardiac output, resulting in a decrease in blood pressure and enhancing the heart functions.
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   Ask your doctor about open heart surgery or catheterization if your heart condition is severe. Catheterization is done by threading a catheter from your large groin artery to your heart.

   • During open surgery, surgeons will replace a damaged valve or treat it, and in cases of septal defects, sew holes in the heart.
   • The surgical option will only be advised by your doctor or surgeon depending on the severity of your condition and if all other therapy solutions do not work.
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Method 3

Method 3 of 5:

Part 3: Getting a Diagnosis

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   Make sure your doctor checks your heart with a stethoscope during a routine physical exam. One way to cope with your heart murmur is to get an official diagnosis from your doctor. Your doctor will be able to hear any abnormal sounds with his stethoscope. Listening carefully, he may be able to determine their loudness level, location timing and repetition to evaluate whether they are harmless or abnormal.
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   Get a referral to see a cardiologist. If your doctor suspects a heart murmur, he will refer you to a cardiologist or a pediatric cardiologist, if the patient is a child. A cardiologist is a specialized doctor in the cardiac diseases field.

   • The cardiologist will use their stethoscope to grade the heart murmurs on a scale from one to six, one being very low and six being very high.
   • They will also look at the exact point at the heartbeat’s rhythm that the murmur is heard, its duration and whether it is heard more in the chest area or if it is affecting the neck veins too.
   • They will also note if any changes your body position or any slight physical activity affects the murmurs, causing them to sound louder or more obvious.
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   Allow your cardiologist to examine your medical history and your family’s medical history. They will check if your family has a history of heart disorders and any first signs or symptoms of heart problems that you or someone in your family has developed.

   • They will look at your medical profile and check for other underlying diseases that can result in a heart murmur such as rheumatic fever.
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   Tell your cardiologist if you are experiencing any chest pain, dizziness, or have a history of fainting. This information will help them determine the murmur’s severity and grade it correctly.

   • The cardiologist will also check for any symptoms appearing on your body, such as swelling at your legs, feet, or the facial area, any signs of skin discoloration at the extremities or at the lips. They may also look for abnormal or delayed growth in children as this may indicate heart issues.
   • Depending on your physical symptoms, the cardiologist will determine if your murmurs are innocent or abnormal. For abnormal sounds they will do further testing on your heart.
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   Get a chest x-ray. This will give your doctor a clear picture of your chest area, lungs, heart and surrounding blood vessels. It will also show any enlargement of your heart to more than its usual size and any heart related problems that may be causing your murmurs.
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   Get an “ECG”. An electrocardiogram or “ECG” is done to give your doctor a chart of your heart’s electrical signals or your heart rhythm. They will check the electrical waves drawn on the chart to detect any abnormalities. Any wave abnormalities may indicate defects in the heart structure and function.

   • An “ECG” is done by putting special electrodes on your chest. It does not hurt, although the gel that is used with the electrodes is often cold and you may feel some slight discomfort when the electrodes are removed.
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   Get an echocardiography. This procedure uses ultrasound waves to get a detailed image of your heart’s shape, size and the internal structures of the chambers and valves. This imagery is very helpful as your cardiologist can observe your heart while it is contracting and pumping blood to locate areas that are not functioning properly.

   • This test should be performed at a resting state and during stress, or stress echo, where the patient is asked to perform some exercises to exert stress on the heart so it works and pumps faster. This may then reveal or provoke any signs of a heart problem.
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Method 4

Method 4 of 5:

Part 4: Recognizing the Symptoms

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   If you have an innocent murmur, expect to display no symptoms. Beyond a loud or abnormal heart beat, your doctor will detect no other symptoms. In fact, this type of murmur will not cause harm to you or restrict your physical activities.
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   Get your infant or baby checked for a congenital heart defect. Look for signs of cyanosis (bluish of the skin) on their extremities, their face or their lips due to a decrease in the heart’s ability to pump adequate blood. They may also be growing at an abnormal rate and you may have difficulties feeding them.
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   Notice if you are short of breath, have chest pains, or swelling or edema in your lower extremities. You may also have increased sweating when doing even limited physical activity and constant dizziness or drowsiness.
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   Check your neck veins to see if they are enlarged. Patients suffering from heart valve defects are usually seen with palpitations or irregular heartbeats that can cause large neck veins. This is due to abnormalities as the heart beats and the decrease in its work out, which can cause an elevation in blood pressure. This will result in signs of hypertension like edema.

   • Your doctor may also notice that you have an enlarged liver or hepatomegaly. An abnormal heart murmur will cause an increase in pressure in the inferior vena cava and the hepatic veins that carry blood from the liver, causing congestion and blood to be retained back at the liver, and its enlargement.
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Method 5

Method 5 of 5:

Part 5: Identifying the Two Types of Heart Murmurs

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   Understand how your heart works. Your heart consists of four chambers and four valves. The two upper chambers are called atria and the lower chambers are called ventricles.

   • The right atrium collects the non oxygenated blood from the superior and inferior vena cava (two large veins) and pours the blood into the right ventricle through the Tricuspid valve.
   • The right ventricle then pushes the non oxygenated blood to the pulmonary artery where the blood moves into the lungs through the Pulmonary valve.
   • After making this gas exchange, the oxygenated blood returns back to the heart to the left atrium, which then transfers it to the left ventricle through the Mitral valve.
   • The left ventricle then pushes the oxygenated blood to the aorta artery and the blood moves to different body organs through the Aortic valve.
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   Imagine heart valves like doors or gates in your heart. They allow blood to be transferred in only one direction, preventing it from returning backward through any valves. The “lub-Dub” sound comes from the heart valves opening and closing.

   • When the two ventricles squeeze to contract, the Tricuspid and Mitral valves are both closed to allow the blood to enter into the pulmonary and aorta arteries respectively, and not to return back to the atriums. This process is called the “Systole” and is heard as the first “lub” sound in your heart beat.
   • When the two atriums squeeze to contract, the two ventricles are relaxed to receive the blood from them and the Pulmonary and Aortic valves both close. This process is called the “Diastole” and is heard as the second “Dub” sound in your heart beat.
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   Do not be too concerned if you develop an innocent or “harmless” heart murmur. Innocent heart murmurs usually happen to a person with a healthy heart. The exact cause is not fully known, but one theory is that they can develop when the blood travels through your heart parts more rapidly or with a less smooth movement. Innocent murmurs do not indicate a problem in your heart, though they may persist for a while, or may last for the rest of your life with no detrimental restriction or limits to your physical activity.

   • Harmless murmurs can be caused by physical activity, fever, hyperthyroidism (excessive release of the thyroid hormone), or anemia (less amount of red blood cells “RBCs” to carry oxygen to tissues). All of these conditions can cause your heart rate to speed up, or alter the volume of your blood circulation.
   • Innocent heart murmurs can also develop during pregnancy. The blood circulation in a pregnant person is bigger than normal in order to deliver adequate nutrition and oxygen to the fetus.
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   Note if you were born with an abnormal heart murmur. This type of murmur can be congenital (from birth), due to abnormalities or defects at certain sites in the heart structure. Several conditions result in an abnormal heart murmur, including:

   • Septal defects, which are holes in the septum wall separating the right side from the left side of the heart. You may have atrial septal defects that are between the two atriums or ventricular septal defects that are between the two ventricles. This defect is congenital and can cause an alteration in the velocity or direction of blood, resulting in heart murmur sounds.
   • You may have been born with valve abnormalities, such as stenosis to the valves, which can decrease the amount of the blood due to their narrowing. You may also have valve regurgitation, which means that valves can’t totally close, causing the escape of some blood through the valves.
   • Hypertrophic cardiomyopathy is the enlargement and thickening of the left ventricle muscles. This can decrease the heart’s blood velocity and pumping speed into the aorta, resulting in a blockage. This also harms the mitral valve by putting extra pressure on it that may cause some blood to escape backwards. This also puts extra pressure on the heart muscles to contract and to be able to push blood properly.
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   Be aware that certain disease developed in adulthood can lead to an abnormal heart murmur. These disease or conditions include:

   • Rheumatic fever, which is an acquired disease from an untreated sore throat or a strep infection. The incomplete cure from a strep infection can affect the heart valves, causing scarring and affecting normal blood flow, which will lead to murmur sounds.
   • Endocarditis, a condition usually seen in patients suffering from a heart defect. This condition is caused by the inflammation of the inner myocardium muscles and valves due to the spread of bacteria from other sites in your body through the blood circulation. The original heart defect can cause blood clots near the heart valves. These clots can then cause the bacteria to multiply, leading to inflammation that can become a life threatening case.
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