Heart Murmur in Babies & Children
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After the birth of a child, a regular check-up with your paediatrician is a must. During these visits, the doctor listens to the baby’s heartbeat for abnormalities. One of the most common diagnosis is that of a heart murmur. The name may sound very intimidating and worrisome, but heart murmurs are very common among children and, in a majority of the cases, are not harmful.
What Is a Heart Murmur?
Heart murmur technically refers to an additional swishing noise in the heart that is heard besides the regular ‘lub-tub’ beat. When the blood passes through the four different chambers of the heart, the auricles and ventricles close and open in a very rhythmic fashion to create the typical sound of the heart-beat.
For different reasons, your child’s heart may produce an extra murmuring sound. This is picked up by your doctor during a regular visit as part of his first-line assessment. Many times, this heart murmur is innocent and does not indicate any serious underlying condition. Further clinical evaluation is usually done to characterise the reason behind the whooshing sound.
How Common Are Heart Murmurs in Infants and Kids?
Heart murmurs are pretty common among children. In fact, many expert opinions suggest that almost 90% of the children between the age of four and seven show signs of having a heart murmur. Occasionally, about one in a hundred children who have heart murmur turn out to have an underpinning defect in their heart. A baby heart murmur is usually evaluated with more caution to rule out any abnormalities.
What Happens in Heart Murmur
The heart of babies tends to beat at a very fast rate, compared to growing children or adults. Many times, an additional sound is heard in a fraction of a second between a ‘lub-tub’. Harmless murmur is, usually, a slightly altered sound of blood flow in the heart and does not signify any major heart problem. In the case of a congenital defect in the valves or the blood vessels, the heart murmur is more pronounced and reflects the abnormality in the flow of blood.
Innocent murmurs are harmless murmurs mostly diagnosed in babies. These children usually do not exhibit any kind of symptoms and continue to have an active and playful life. The murmur, in this case, comes as a result of the noise of blood flowing in a certain way or due to some minor structural variations. An innocent murmur is diagnosed, between the ages of zero and five, by the physician by carefully listening to the heartbeat. Sometimes, the doctor prescribes some primary tests to rule out any underlying congenital defect.
Causes of Child Heart Murmur
If an innocent murmur is ruled out, then the swishing sound can arise because of a defect in the heart. One in a hundred children with heart murmur has congenital defects arising in the valves or the major blood vessels. This inherent abnormality alters the pattern of blood flow, creating the characteristic murmur noise. Defects in the septum, separating the valves in the form of improper closure or a hole can cause a heart murmur. Transposed blood vessels also manifest as a heart murmur. Sometimes, these defects could also arise from endocarditis or rheumatic fever, and the doctor evaluates the child completely for the plausible reasons for murmur.
Premature children with heart murmur can have a condition called patent ductus arteriosus (PDA). This is a condition in which, the opening between two major blood vessels fail to develop in the foetal stage and is characterized by a heart murmur and poor weight gain. Sometimes, it is the only symptom that the child shows, making it a very critical diagnosis.
Signs and Symptoms of Heart Murmur in a Child
Children with innocent heart murmurs are usually asymptomatic. However, children with heart defects show more sweating, slower growth and breathlessness. Infants with congenital abnormalities usually sweat a lot while being fed and also exhibit signs of breathing difficulties.
Diagnosis of Baby & Children Heart Murmur
The first step of diagnosis is to record the severity of the heart murmur by simply hearing it with a stethoscope. The sound is given a score from one to six and based on the score it is further taken for evaluation. The kind of sound, the timing of the murmur and other such things are also recorded. Sometimes, the doctor monitors the murmur over a period of time during regular checkups.
If the doctor suspects an underlying heart issue, he usually prescribes some evaluations like a chest X-ray, ECG or an echocardiogram. An echocardiogram is a scan of the various parts of the heart that can capture an abnormality in it.
Are Heart Murmurs Signs of Something Else?
Mild heart murmurs, usually, do not signify anything abnormal. However, some cases can indicate a vessel or valve problem in the heart. Some children who show symptoms like a blue colouration of skin, feeding and breathing difficulties also exhibit heart murmur as a symptom of blood mixing due to cyanotic heart disease. A complete evaluation is usually done by the physician if he suspects any abnormality.
Harmless heart murmurs usually settle down with age and do not require any specific treatment. In the case of a congenital defect, like a hole in the valve or improper closure, there is a good chance of it getting corrected by itself. Some medications are given to support the normal functioning of the heart. Rarely, corrective surgery is performed on children to improve their quality of life. Some critical corrective surgeries are done after the child grows to a certain age to minimize the risk of failure. As the child grows, regular check-ups with the paediatric cardiologist are necessary to monitor the heart functioning.
1. My baby’s heart is beating fast sometimes. Is it normal?
Babies naturally have a higher heart rate touching up to 130 beats per minute, compared to growing children or adults. Their heart beats faster when they are crying or when they have a fever. Some decongestants and asthma drugs tend to increase the heartbeat rate. If the child has a noticeably higher heart rate with visible discomforts, then it is advisable to seek immediate medical help.
2. If my baby’s heart is pounding or skipping a beat, should I worry about it?
Pounding or skipping a beat can be a very momentary fluctuation in the functioning of the heart. If there are any signs of abnormality for a prolonged period of time, then flag it to your doctor at the earliest.
Heart murmur in a newborn baby is a common diagnosis that arises during the regular medical checkups. Majority of the cases correct themselves with time and are harmless. Talking to your healthcare provider about the dos and don’ts for your baby with heart murmur can go a long way in improving the quality of life and better ensure a better prognosis.
Also read: Fast Heart Beat During Pregnancy