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Heart Murmurs

What is a heart murmur and how to investigate it?

Heart murmurs are commonly found during routine physical examination. They are described as abnormal sounds heard during auscultation with a stethoscope. While some heart murmurs may be harmless, others can indicate underlying heart conditions that require further evaluation and treatment. 

Heart murmurs can result from various heart issues that cause a turbulent flow of blood through the heart chambers and valves. The most common cause of a heart murmur is a problem with one of the heart valves, such as narrowing (stenosis) or leakage (regurgitation). Commonly affected valves are aortic valve, mitral valve and tricuspid valve. Less frequently observed are congenital (present at birth) heart defects, such atrial septal defects (ASDs) or ventricular septal defects (VSDs), which are often referred to as `holes in a heart`. Sometimes, murmurs may be entirely benign, so called flow murmurs. 

Pathological, important heart murmurs may be associated with symptoms such as chest pain, shortness of breath, palpitations, or ankles swelling. Timely identification and evaluation of pathological murmurs are essential for appropriate diagnosis and management to prevent adverse outcomes. 

Majority of heart murmurs can be monitored in a long term and no immediate intervention is required. However, being closely followed up in an outpatient setting allows timely management if a heart murmur was to become clinically significant. Depending on the starting severity of a heart murmur, follow up is arranged from every 6 months to every 3 to 5 years. Clinical consultation followed by a test called an echocardiogram are usually sufficient to establish next management steps.

To assess the significance of a heart murmur an echocardiogram (Echo) is utilised. Echocardiogram is a non invasive test, based on ultrasound technology and it takes around 30 minutes to perform. At Dr Bart’s clinics, our structure enables us to conduct an echocardiogram during the initial consultation itself. This streamlined approach allows for prompt confirmation of diagnoses and immediate initiation of treatment or provide reassurance to concerned patients without delay.

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