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Heart Murmurs in babies, causes, early symptoms and treatment options

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Heart murmurs in babies do not always indicate heart disease. Sometimes, your baby's heart murmur could be an innocent one too. Read on to know more about heart murmur in babies and when you should be concerned

Infant to Toddler
Heart Murmurs in babies, causes, early symptoms and treatment options
Heart murmurs alone do not indicate heart disease

As a parent, it is normal for you to feel concerned about your baby's health. Even a minor bout of cold, fever or indigestion affecting your little one can make you feel worried. So, if your child's doctor tells you that your baby has heart murmur, fear and panic are bound to set in. You would want to know what heart murmur is, the signs and symptoms to look for and the treatment options available.

Knowing more about the condition, heart murmur in babies would help you and your family worry less and handle the situation in a better manner.

Dr Binoy John, leading interventional cardiologist, gives a broad outline of what cardiac murmur is, the possible causes, how it can be identified and how likely it is to affect your child's health.

Excerpts from a chat:

What is heart murmur?

Doctors listen to a baby's heart as a part of routine check-ups. By listening to the heart, a doctor can determine if there is any variation from the standard sound pattern.

A normal human heart makes a typical 'lub-dub' sound as it beats within the chest. The 'lub' indicates closure of the heart valves after the blood flows from the upper to the lower heart chambers. The 'dub' sound is made by the closure of a different set of valves after the blood flows out of the heart to the body.

In some cases, the doctor may detect a series of prolonged, audible vibrations which sound like swishing or whooshing. These abnormal sounds indicate the presence of heart murmurs.

What causes heart murmurs?

Heart murmurs in babies are caused by abnormal blood flow through the heart. However, the swishing or whooshing sound could also be the sound of blood flowing normally through the valves.

There are various causes for heart murmurs. For example, blood flowing faster than usual through the heart or the presence of fever. Such murmurs don't need any specific treatment. They are called normal, functional or innocent murmurs.

Abnormalities within the heart, like a thickened or leaking valve, or a hole can also cause heart murmurs. These murmurs are called pathological murmurs, as they are caused by a heart diseaseĀ or deformity. If the baby is diagnosed with any heart problem, the paediatrician would refer them to a paediatric cardiologist for further treatment.

"Heart murmurs are caused by flow turbulence across the heart which can arise due to obstructions in the flow of blood, across abnormal valves or a hole in the heart. Heart murmur, not caused by the above factors go away with time. These are called 'innocent murmurs.' But if the murmur is because of an abnormality, it will stop only after it has been treated," says Dr Radha Krishnan, Director, Paediatric Cardiology, at a leading hospital.

How soon can a heart murmur be identified?

The heart and lungs of a baby undergo functional and structural changes for weeks, and even months after birth. Therefore, it may take days, weeks or months for a murmur-causing heart problem to develop.

On the other hand, a defect which causes a murmur when the child is born may clear up in a couple of days or weeks, as the heart develops. An example of this is a condition known as 'ductus-arteriosus', which usually disappears within three months of birth.

Atrial septal defects and peri-membranous ventricular septal defects are referred to as 'holes' in the heart in layman's terms. These can also cause heart murmurs in babies. However, these too can disappear in a couple of years.

When to worry about heart murmur

If your baby has a normal heart murmur, she may not show any signs or symptoms. However, it is advisable to get your baby examined by a doctor if they have any of the following symptoms:

  1. Bluish skin color, specifically on the lips and fingertips; this is a sign of congenital heart defect in babies
  2. Slow weight gain, poor feeding and poor appetite
  3. Swelling or oedema in the feet, abdomen and neck veins
  4. Shortness of breath, difficulty in breathing or breathing fast
  5. Dizziness or fainting
  6. Sweating

Evaluation and management of heart murmurs in children

How a child with heart murmur would be affected depends on various factors like the presence of physical abnormalities, difficulties in feeding and breathing, poor weight gain and delayed developmental milestones.

A thorough physical check-up at the first examination is vital to identify possible defects that could cause heart murmurs. So, take your baby for examination as per the schedule recommended by the paediatrician. This will help identify any late-onset manifestations of birth defects, including those related to the heart, which could result in a murmur.

Any suspicion of a birth defect that causes a murmur can easily be either confirmed or ruled out by an echocardiogram. This test uses sound waves to visualize the baby's heart and major blood vessels and identify abnormalities, if any.

With advancements in technology, elaborate foetal-echocardiogram facilities are now available. A gynaecologist can use this technique to identify major and complex birth defects even when the foetus is as young as 18 weeks. This gives prospective parents the opportunity to decide on whether to terminate the pregnancy or go ahead with it.

Heart murmurs are a common childhood problem, and most of the time, they disappear as the baby grows. If your baby is diagnosed with a heart murmur, seek the specialist's consultation without delay to identify the cause. In case, the murmur is caused by a pathological issue, the paediatric cardiologist will be able to guide you on available treatment options.

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