What A Heart Murmur May Mean, And When To Review It
Has a doctor ever paused during a routine check, listened a little longer with the stethoscope, and mentioned that you have a heart murmur? Or perhaps a paediatrician said the same about your child years ago, and the phrase has been sitting quietly in the back of your mind ever since. It is easy to hear the word "murmur" and imagine something serious. In many cases, the reality is far more reassuring, though not always. So what does a heart murmur actually mean, and when does it deserve a closer look?
This article walks you through what a heart murmur is, what may cause one, when it may be harmless, when it may be worth reviewing, and what an assessment usually involves.
Heart murmur in plain terms
A heart murmur is an extra sound heard between the normal beats of the heart. Instead of the familiar "lub dub", a doctor may hear a soft whooshing, blowing, or swishing sound during the exam. This sound is caused by blood moving through the heart in a way that creates turbulence.
Some murmurs are entirely harmless. Others reflect something worth understanding more closely. What a murmur means depends on when it occurs during the heartbeat, how loud it is, where it is heard, and what other findings accompany it.
Because a murmur is a sound rather than a diagnosis, it is best thought of as a clue rather than a conclusion.
Types of heart murmurs
There are two broad groups worth knowing about.
Innocent heart murmurs
Innocent murmurs, sometimes called functional or physiological murmurs, are common and generally harmless. They often occur simply because blood is moving briskly through a healthy heart. Innocent murmurs may be picked up in:
Children and teenagers, where the sound often fades with age
Pregnant women, due to increased blood flow
People during periods of illness, fever, or anaemia
Adults who are physically active or have a slightly higher heart rate
Innocent murmurs usually do not need treatment. They may be followed up over time to make sure they remain unchanged.
Murmurs related to a heart condition
Other murmurs reflect an underlying structural or functional change in the heart. These are sometimes called pathological murmurs. They may relate to:
Heart valve narrowing or leaking, which can affect blood flow direction
Congenital heart conditions present from birth
Damage from previous illness or infection
Long term strain on the heart from high blood pressure or other heart disease
Not every murmur in this category is urgent, but they usually warrant a proper look to understand what is going on and what, if anything, may need to be monitored.
What may cause a heart murmur
So what actually creates that sound? Common contributors include:
Fast blood flow through a normally structured heart
Valve issues such as narrowing (stenosis) or leaking (regurgitation)
Congenital heart differences
Anaemia, thyroid overactivity, or fever
Pregnancy
Long standing high blood pressure
Previous rheumatic fever or infection affecting the heart
The important point is that a murmur can arise from something entirely benign or from something worth investigating. The context in which it was picked up usually shapes what comes next.
What a heart murmur may feel like
Do heart murmurs come with symptoms? Often, no. Many people never feel anything and only learn about the murmur during a routine check. When symptoms are present, they usually relate to the underlying cause rather than the murmur itself. These may include:
Breathlessness with activity
Fatigue or reduced exercise tolerance
Swelling in the ankles or lower legs
Chest discomfort
Palpitations
Light headedness or fainting during exertion
A murmur combined with any of these symptoms is more meaningful than a murmur found on its own during a healthy person's checkup.
When a heart murmur may be worth reviewing
So how do you tell whether a murmur is worth a closer look? Some patterns are more informative than others.
A newly detected murmur in an adult
A murmur first noticed in adulthood, particularly if it was not present in earlier examinations, often deserves review. New findings can reflect changes in the heart valves or other structural changes.
A murmur accompanied by symptoms
Breathlessness, fatigue, chest discomfort, or fainting alongside a known murmur may point to an underlying issue that warrants assessment.
A childhood murmur that is still present in adulthood
Some innocent murmurs fade with age. Others persist for good reason. If a childhood murmur is still audible in adulthood, particularly with any new symptoms, a check may be helpful.
A murmur during pregnancy that does not settle
Pregnancy commonly causes innocent murmurs due to increased blood flow. These usually resolve after delivery. A murmur that remains months later, or that comes with symptoms, may deserve further review.
A murmur combined with high blood pressure or other heart disease
When a murmur is picked up in someone with long standing hypertension, coronary artery disease, or other heart disease, understanding it in context becomes especially important.
What an assessment usually involves
At Sunrise Heart Specialist Clinic in Sembawang, a cardiologist led review usually begins with a conversation about when the murmur was first noticed, any symptoms you have experienced, and your general heart health history. This may include:
When the murmur was first heard, and by whom
Whether it has been reviewed before
Symptoms such as breathlessness, fatigue, or chest discomfort
Medications you are currently taking
Personal and family history
Depending on the clinical context, investigations may be considered, such as an ECG [link → ECG service page] to check the heart's electrical activity, an echocardiogram [link → Echocardiogram service page] to look closely at the heart's structure and how the valves are functioning, a Holter monitor [link → Holter monitor service page] if rhythm patterns need review, or blood tests to check for contributing factors such as anaemia or thyroid imbalance. The appropriate approach depends on your individual presentation.
The echocardiogram is often the most useful single test for understanding a murmur, since it provides a clear picture of the valves and the heart's pumping.
What happens after a murmur is understood
Once a murmur is properly assessed, one of a few pathways usually follows.
If it is innocent, no treatment is needed, and periodic follow up may be sufficient
If it reflects a mild valve change, monitoring over time is often the main approach
If a more meaningful valve or structural change is found, further review or treatment may be planned
If the murmur is linked to another condition such as high blood pressure, addressing that condition may be the priority
Knowing where the murmur sits on this spectrum often removes a lot of anxiety, which is one of the reasons a proper assessment matters.
Where Sunrise Heart Clinic may fit into next steps
If you have been told you have a heart murmur and are unsure whether it warrants a proper look, that uncertainty alone is often reason enough to check in. At Sunrise Heart Specialist Clinic in Sembawang, Dr Woo Jia Wei works with patients across Singapore who want a clearer understanding of what their murmur may mean and what, if anything, may need to be monitored.
For those who find travelling to a clinic difficult, whether due to age, mobility, or family commitments, home cardiology visits are also available across Singapore. Many families find this an easier way to arrange care for elderly parents or loved ones who prefer being seen at home.
Book a cardiac review with Dr Woo Jia Wei at Sunrise Heart Specialist Clinic in Sembawang. Clinic appointments and home cardiology visits across Singapore are both available.
FAQ
Does a heart murmur always mean something is wrong?
No. Many heart murmurs are innocent and do not reflect any underlying heart condition. Others are related to valve or structural changes worth understanding. What a murmur means depends on its features, the context in which it was found, and any accompanying symptoms.
Can a heart murmur go away on its own?
Some can. Innocent murmurs in children often fade with age. Murmurs during pregnancy often resolve after delivery. Murmurs linked to structural changes usually do not go away on their own and may deserve monitoring.
Do I need treatment for a heart murmur?
Not always. Many murmurs need no treatment at all. Others may benefit from monitoring over time. In some cases, treatment is directed at the underlying cause, such as a valve condition or high blood pressure, rather than the murmur itself.
Can adults develop a new heart murmur?
Yes. A murmur that is first heard in adulthood can reflect changes in the heart valves or other structural changes. A newly detected murmur in an adult is one of the more common reasons a cardiologist will recommend an echocardiogram.
This article is for general information only and does not replace medical advice.
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