Heart Murmur? Why Your Chest Is Noisy & Medically Approved Next Steps

If a doctor has ever paused while listening to your chest with a stethoscope and said, "I hear a murmur," you may have felt confused or worried. The word murmur can sound serious. But in reality, a heart murmur is very common — and often harmless.

Let's break down what a heart murmur actually is, why it happens, and what medically appropriate next steps look like.

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What Is a Heart Murmur?

A heart murmur is an extra or unusual sound heard between heartbeats when a healthcare professional listens with a stethoscope.

Normally, your heartbeat makes two clear sounds:

• "Lub-dub"
  These sounds come from your heart valves closing properly as blood moves through the heart.

A murmur is:

• A whooshing
• Swishing
• Blowing
• Or extra rhythmic sound

It happens because blood flow is turbulent instead of smooth.

Importantly:
A murmur is not a diagnosis by itself. It is simply a sound heard through a stethoscope that signals your doctor to look deeper.

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Why Does a Heart Murmur Happen?

There are two broad categories:

1. Innocent (Harmless) Heart Murmurs

These are very common, especially in:

• Children
• Teenagers
• Pregnant women
• Athletes
• People with fever or anemia

Innocent murmurs:

• Do not mean heart disease
• Often come and go
• Do not require treatment
• May disappear over time

They simply reflect faster or stronger blood flow.

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2. Abnormal Heart Murmurs

These may signal an underlying heart condition. Causes can include:

• Valve problems
  • Valve narrowing (stenosis)
  • Valve leaking (regurgitation)
• Congenital heart defects (present from birth)
• Heart muscle thickening
• Infections of the heart valves
• Aging-related valve changes

In these cases, the murmur heard through a stethoscope is a clue that something structural may be happening.

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How Doctors Evaluate a Heart Murmur

The stethoscope exam is just the beginning.

When a doctor hears a murmur, they evaluate:

• Where it is loudest
• When it happens in the heartbeat cycle
• How loud it is
• Whether it changes with position or breathing
• Whether other abnormal heart sounds are present

Based on this, they decide whether further testing is needed.

Common Follow-Up Tests

If your doctor suspects a structural issue, they may recommend:

• Echocardiogram (Echo)
  An ultrasound of the heart that shows:

  • Valve function
  • Heart chamber size
  • Blood flow patterns
  • Muscle thickness

• Electrocardiogram (ECG or EKG)
  Measures electrical activity.

• Chest X-ray

• Cardiac MRI (in select cases)

An echocardiogram is the most important next step if a murmur seems abnormal.

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Symptoms That Matter

Many people with a murmur have no symptoms at all.

However, you should seek medical evaluation if you notice:

• Shortness of breath
• Chest pain
• Fainting or near-fainting
• Swelling in legs or ankles
• Rapid or irregular heartbeat
• Fatigue with minimal activity
• Bluish lips or fingertips

These symptoms do not automatically mean something severe is happening — but they require medical assessment.

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One Condition to Be Aware Of: Hypertrophic Cardiomyopathy (HCM)

One possible cause of an abnormal murmur is Hypertrophic Cardiomyopathy (HCM). This is a condition where the heart muscle becomes abnormally thick, which can disrupt blood flow.

HCM may:

• Cause a murmur heard through a stethoscope
• Lead to chest pain
• Cause fainting
• Trigger shortness of breath
• Increase risk of abnormal heart rhythms

It can also run in families.

If you have a murmur along with symptoms — or a family history of sudden cardiac death — understanding your risk is important. You can use Ubie's free AI-powered symptom checker for Hypertrophic Cardiomyopathy to assess your symptoms and determine whether you should discuss this condition with your doctor.

This is not a replacement for medical care, but it can help guide your next conversation.

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How Serious Is a Heart Murmur?

Here's the honest answer:

• Many murmurs are harmless.
• Some indicate structural heart disease.
• A small number can signal potentially life-threatening conditions.

The only way to know the difference is proper evaluation.

The good news:
Modern imaging — especially echocardiography — makes diagnosing the cause far more accurate than simply listening with a stethoscope alone.

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When to See a Doctor Immediately

Seek urgent care if a murmur is accompanied by:

• Fainting
• Severe chest pain
• Sudden shortness of breath
• Rapid heart rhythm that won't slow
• Signs of stroke (weakness, confusion, trouble speaking)

These symptoms require immediate medical attention.

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What Happens If a Murmur Is Caused by Valve Disease?

Treatment depends on severity.

Options may include:

• Monitoring with regular echocardiograms
• Blood pressure control
• Medications to manage symptoms
• Antibiotics (if infection is involved)
• Surgical or minimally invasive valve repair or replacement

Many people live long, full lives even with valve disease — especially when it is diagnosed early.

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Heart Murmurs in Children

In children, heart murmurs are extremely common. Pediatricians often detect them using a stethoscope during routine checkups.

Most childhood murmurs:

• Are innocent
• Require no treatment
• Do not limit activity

However, if the murmur sounds concerning or the child has symptoms, further testing will be recommended.

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Can You Prevent a Heart Murmur?

You cannot prevent innocent murmurs.

For murmurs caused by heart disease, you can reduce risk by:

• Controlling blood pressure
• Managing cholesterol
• Avoiding smoking
• Treating infections promptly
• Maintaining a healthy weight
• Exercising regularly (with medical guidance if heart disease is present)

Regular physical exams are important because a murmur is often first detected with a simple stethoscope during routine care.

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What Should You Ask Your Doctor?

If you've been told you have a murmur, consider asking:

• Is this murmur innocent or concerning?
• Do I need an echocardiogram?
• Should I restrict activity?
• Do I need follow-up monitoring?
• Could this be genetic?
• What symptoms should I watch for?

Clear communication helps reduce anxiety and ensures appropriate care.

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The Bottom Line

A heart murmur is a sound, not a diagnosis.

It is detected with a stethoscope, but determining its meaning requires careful evaluation.

Most murmurs are harmless.
Some indicate structural changes in the heart.
A few may signal serious disease.

The key is proper medical assessment.

If you've been told you have a murmur — or you're experiencing symptoms like chest pain, fainting, or shortness of breath — speak to a doctor. Anything that could involve the heart deserves timely evaluation.

And if you're concerned about conditions like heart muscle thickening, especially with symptoms or family history, consider using Ubie's free AI-powered symptom checker for Hypertrophic Cardiomyopathy before your appointment so you can have a more informed discussion.

Your heart makes noise for a reason.
Listening carefully — with a stethoscope and the right follow-up — ensures that nothing important is missed.