Murmurs are usually innocent, but can also indicate disease. A heart murmur is like a breath is heard when listening to the heart noise. This sound, which is usually described in medical textbooks as whistling, squeaking or rasping, sometimes reflects a stream of blood flowing abnormally to the heart. The beat of a healthy heart is described by two noises, whose usual onomatopoeia are ‘lub’ (the first sound) and ‘dub’ (the second sound). These sounds correspond to the opening and closing of the heart valves. Types of Heart Murmurs Not all abnormal heart sounds are clinically significant. Up to 50% of people with a heart murmur have a completely normal heart. Such murmurs, called functional or innocent murmurs, are common in children and may not require treatment and usually disappear upon reaching adulthood. Other cardiac murmurs may be symptoms of a serious heart problem, indicating that one of the blood vessels of the heart is narrowed or a heart valve is damaged. It can also mean that the heart does overexertion or there is a hole in the wall that divides the left heart and also that there are alterations in the implementation of the vessels that drain from the heart. Murmurs in Pregnant Women, Children and Elderly Normally, in pregnant women heart murmurs are harmless and may increase the flow rate of blood. Such murmurs are also common in young children and older as a normal part of the development. These noises are often caused by the speed with which blood flows through the heart structures. Most murmurs are common and harmless and do not involve any danger to the health. They are also common in elderly because of hardening of the walls of blood vessels, valves and other tissues that occurs with aging. Causes of Heart Murmur The heart murmur can produce abnormal sounds due to the following reasons; • A heart valve that is thickened or is not normal. The malfunctioning of the valves may be several as a result of rheumatic fever or the presence of atherosclerosis, which tends to affect mainly the aortic valve. • An abnormal communication between two cavities, mainly between two atria or between two ventricles due to a congenital heart disease. • Arteriosclerosis, besides affecting the heart valves can damage arteries, narrowing them and producing an abnormal turbulence in the normal flow of blood and emitting a rhythmic hiss in arteries. • Various processes as having hypertension, pregnancy, anemia, fever or overactive thyroid gland. • Congenital abnormalities of both the muscle structure and cavities as the arteries and veins are connected to heart. Symptoms Functional, innocent murmurs or those that involve a mild disease have no symptoms and are often an incidental finding. Murmurs that reflect an important disease, affecting even the growth, greatly limit exercise capacity and the presence of a bluish discoloration of the lips or fingertips. Murmurs may be discovered during a medical examination because of other symptoms, often not related to them such as in case of chest pain, shortness of breath or palpitations. Diagnosis To detect intermittent heart murmur, the doctor will perform a cardiac auscultation using a stethoscope placed on the chest and back to hear the heartbeat. Since blows change with body position or breathing, it is normal that your consultant may ask you to breathe deeply and hold your breath while the doctor listens to heart. The Treatment The functional heart murmurs usually do not need any treatment. If the breath is associated with an underlying disease such as hypertension, it will be necessary to treat the disease. If the heart murmur is due to valvular disease or other heart defects, you may require the administration of medication or surgery.