Heart murmurs aren’t always harmless. In adults, they frequently signal an underlying problem with the heart’s valves, said Dr. Feras Aloka, M.D., an interventional cardiologist at the Detroit Medical Center.
“A normal heart would produce your typical lub-dub heart sound when the valves close,” Aloka said during an appearance on Live in the D. “A heart murmur is a whooshing or swishing sound that happens when blood is going through either the heart chambers, but more likely through the heart valves.”
While murmurs can be benign in children, during pregnancy or with conditions such as infection or anemia, “a lot of times in adults, a heart murmur could be because of a heart valve disease,” he said.
When Valves Wear Down
Heart valve disease often develops gradually, and age-related wear is a leading cause.
As valves stiffen and fail to open fully, the heart must push harder to move blood forward — a condition known as stenosis. In other cases, valves do not close properly, allowing blood to leak backward. “We call that regurgitation,” he said.
Other causes can include infections, prior chest radiation and congenital defects present at birth.
Symptoms That Shouldn’t Be Ignored
Valve disease can be subtle at first, but symptoms tend to escalate as the condition progresses.
Common warning signs include:
- Shortness of breath
- Reduced exercise capacity
- Chest pain
- Dizziness or fainting
- Leg swelling
- Fatigue
- Heart palpitations
“A lot of patients come to us complaining of shortness of breath … dizziness, lightheadedness, or even passing out,” Aloka said, noting that irregular heart rhythms such as atrial fibrillation can accompany valve disease.
Detecting the Problem
Diagnosis often begins with something simple: listening.
“A detailed history and physical examination where you’re actually listening to the patient” often detects a murmur, Aloka said.
An echocardiogram — an ultrasound of the heart — allows physicians to watch the valves open and close in real time. In more complex cases, “you might need a cardiac MRI or even a heart catheterization, which is a minimally invasive procedure,” he said.
From Monitoring to Surgery
Treatment depends on which valve is affected, how advanced the disease is and how much strain the heart is under.
Options can include routine monitoring and medications such as diuretics to ease symptoms. For more serious cases, doctors may “repair or replace that valve through a minimally invasive approach” using catheters inserted through the groin, Aloka said.
“Sometimes for the severe cases … they might still require open-heart surgery.”
A Message for American Heart Month
February marks American Heart Month, and Aloka urged anyone experiencing symptoms to seek medical evaluation.
“You put that stethoscope on the chest, and you hear that sound,” he said. “You hear it, definitely.”
To watch the full segment, click on the video above.
For free heart health information — and a chance to win a smartwatch — visit DMC.org/HeartWin.