Heart Murmur in Infants

Heart murmurs are quite common in healthy adolescents, children, and even infants. However, in some cases, a murmur may indicate a serious heart disease. People with a family history of congenital heart disease are at a greater risk of developing a heart disease, and a murmur may hold much more importance in that case. You may also experience heart murmurs due to alcohol, certain medications, history of rheumatic fever, Kawasaki disease, and certain genetic disorders. This condition may have many different reasons as well.

What Could Be the Reasons Behind Heart Murmur in Infants?

Heart murmurs can be of two types: abnormal murmurs and innocent murmurs. An innocent murmur is more common in newborns and children and is harmless. An abnormal heart murmur may indicate congenital heart disease in children. In adults, they indicate acquired heart valve problems.

Innocent Heart Murmurs

It occurs when blood flows rapidly through the heart. Several conditions can make the blood flow rapidly than normal through the heart. The list includes physical activity, fever, and an excessive amount thyroid hormone in the body. Your child may also experience innocent heart murmurs where the levels of red blood cells are low. In most cases, these types of heart murmurs go away with time, but sometimes, they last for entire life. They do not cause further health problems though.

Abnormal Heart Murmurs

These types of heart murmurs are usually the outcome of structural problems of the heart. There are a number of congenital defects causing heart murmurs. For instance:

• Cardiac shunts or holes in the heart: The condition may or may not be serious and usually depends on the size of the hole as well as its location. Your child develops cardiac shunts when the blood flow between the blood vessels and heart chambers is not normal.
• Heart valve abnormalities: Babies are usually born with congenital heart valve abnormalities, but they sometimes go undetected until much later in life. Sometimes valves do not allow enough blood through them, and on other occasions, they do not close properly.

In addition to congenital heart defects, infections and certain conditions can also damage the structures of the heart and cause heart murmur in infants. For example:

• Valve calcification: This refers to the thickening or hardening of valves, as in aortic valve stenosis or mitral stenosis. These valves sometimes become narrow and limit how much blood can pass through them, resulting in murmurs.
• Endocarditis: It is the infection of the inner lining of the heart and valves. It occurs when bacteria or other germs move from another part of the body through bloodstream and enter the heart. When left untreated, the condition can destroy the heart valves. It is more common in people with preexisting heart valve abnormalities.
• Rheumatic fever: Your child develops this serious condition when do not seek proper treatment for a strep throat infection. Not only can it affect the heart valves, it can also interfere with blood flow through the heart.

When to Worry About Heart Murmur in Infants

Newborns are at a great risk of having congenital heart defects; in fact, about 1% of newborns have a heart murmur, and about 31% to 86% of these newborns have structural heart disease. It is therefore a good idea to take your newborn or child to a pediatric cardiologist for further evaluation. Sometimes, potentially life-threatening heart defects are asymptomatic.

You should take your child to the doctor if you notice issues such as difficulty feeding, rapid breathing, failure to thrive, and blueness in the lips. Symptoms in older children may include chest pain, fatigue, and difficulty doing physical activity.

How to Diagnose a Heart Murmur

Heart listening exam conducted with the help of a stethoscope helps hear a murmur. It is difficult to hear a murmur when a child is uncooperative and cries a lot. It is important to calm the child first before conducting the exam.

Depending on their loudness or intensity, heart murmurs are rated on a scale of 1 to 6 – Grade 1 is barely audible, while Grade 6 is the loudest. The doctor will also pay attention to the location where the murmur is best heard and also consider if the murmur is soft or harsh blowing. The doctor will also consider if the murmur changes when your child changes position. She or he will consider all these points and then decide if you should take your child to a pediatric cardiologist.

Treatment Options

Innocent heart murmurs do not require treatments, they will disappear over time. However, it is important to follow the doctor's advice when it comes to abnormal heart murmur in infants. Here are some treatment options.

Medications

The doctor will prescribe medications depending on the type of heart problem your child has. Some of the most common medications include the following:

• Medications to prevent blood clots
• Water pills to lower blood pressure
• Statins to lower cholesterol levels
• Beta-blockers to lower heart rate and control blood pressure

Surgery

Medications do not help with different valve conditions, and that is when surgery is recommended. Your child may have to undergo a valve replacement surgery in most cases. The options include the following:

• Open heart surgery: The procedure involves removing the narrowed valve and then replacing it with a tissue valve or a mechanical valve. This treatment proves quite effective for severe valve stenosis.
• Transcatheter Aortic Valve Replacement (TAVR): This less invasive procedure involves replacing the aortic valve with a prosthetic valve through an artery in the leg. The surgeon may operate through a small incision in your child’s chest. The procedure is usually recommended for people with severe aortic valve stenosis.