And during a simple routine checkup with the pediatrician, you hear that your child has a heart murmur! As with any unknown issue, especially concerning such an essential organ for survival, it’s impossible not to worry! But to inform and even reassure parents, let’s clarify some points on the subject, since a heart murmur in children isn’t always a sign of risk or that your child will have heart problems in the future.

Then other questions come up such as: How can the pediatrician know there’s a murmur during a simple exam? Why wasn’t this detected earlier? And what did the doctor see to say my child has a heart murmur? The answer is very simple: during the heart auscultation procedure that the pediatrician does at every visit, a different sound is noticed in the heartbeat. This sound is the noise the blood makes as it flows through the blood vessels and valves of the heart, which is clearly heard by the pediatrician between the beats.

In the vast majority of cases, the heart murmur is completely harmless to the child and does not produce any symptoms other than the distinctive sound heard during the heartbeat. This type of murmur is called harmless or benign by pediatricians, or is also considered physiological. It’s quite common for the murmur to be noticed in the first days of life, as the circulatory system, which previously depended entirely on the placenta, goes through changes when the baby begins to use their lungs. In this case, the murmur usually disappears after a few weeks and should be monitored by the pediatrician. If the noises do not go away, further tests should be ordered to assess the situation.

When there is some abnormality in the heart, the murmur comes along with other symptoms such as difficulty feeding, rapid and labored breathing, bluish lips, and poor weight gain. But there are also cases where the heart murmur is only discovered later, sometimes when the child is already older. This shows how important it is for every child to have monthly check-ups with a trusted pediatrician.

Today, with modern equipment designed to diagnose diseases and problems in the baby while still in the womb, it is also possible, during a morphological ultrasound, to detect heart problems or any other malformation in the area. Early diagnosis is extremely important so your obstetrician and specialists can be prepared if intervention is needed after birth.

What Tests Are Done to Diagnose a Murmur?

As mentioned, even through auscultation during the exam, the pediatrician may already know about the murmur, and in some cases, may even be able to gauge its severity. However, only through follow-up diagnostic tests that the pediatrician will order can the diagnosis be confirmed, allowing for the proper treatment and, if necessary, referral to a cardiologist.

One of the tests often ordered is the echocardiogram, which is an ultrasound that shows images of the heart chambers, where it is possible to see the organ’s anatomy and how it functions. If this test shows a heart problem, other tests may be requested, such as a chest x-ray that not only shows the heart chambers but also their size and shape, revealing how the lungs inflate with air.

An electrocardiogram is also commonly ordered. This is a quick, painless procedure in which electrodes are placed on the child’s chest. These electrodes measure the electrical activity in the heart to confirm if there is any change in its function. The most common heart problems include:

  • Malformation of the interventricular septum – This is the most common cause of heart murmurs in children. However, in 80% of cases, no intervention or treatment is needed, as the opening closes on its own in the first years of life.

  • Malformation of the atrial septum – In this case, the opening is located between the two upper chambers of the heart. To solve this, a catheterization is required. Currently, catheterization has become a simple procedure.

  • Pulmonary stenosis – This is the narrowing of the valve of the lung or the artery found in the right upper ventricle of the heart.

  • Aortic stenosis – This is the narrowing of the aortic valve, which puts extra workload on the left ventricle.

In some cases, the treatments above may not be suitable for your child’s specific condition as determined by the cardiologist. If surgery is needed, remember that modern techniques provide all the support necessary for reliable treatment. Surgeries are no longer as invasive as they once were, and scars are often barely noticeable.  Don’t panic if you hear your child has a heart murmur; the murmur may be physiological and disappear over time. Get the recommended tests for evaluation and follow your doctor’s recommendations.

See also: Folic Acid in Pregnancy Prevents Malformation22

Photos:  Nevit Dilmen,  Val Gempis,