'Innocent' Heart Murmur??

[Reg]

My 4 year old son went to a new pediatrician for his annual physical.  The doctor asked if anyone had mentioned that he had what's called an "innocent" heart murmur.  He said it was nothing to worry about and that if we were ever asked if there was a history of heart murmurs on a medical form, we were not to check it (ex., dentist medical history form).  I would like your opinion on his comments and his direction to not notify other health care professionals that it exists.  Any additional information you can give me on this condition, which I have never heard of before, would be greatly appreciated.

[Cleveland Clinic, MD]

The word 'murmur' comes from the Latin word for sound and in medical usage means an disturbance in the blood flow causing a swishing type of sound.  There are many different types of murmurs but the most common usage of the word is for an abnormal (either leaky or tight) heart valve. An 'innocent murmur' (also called a functional murmur or Still's murmur) is just that - a murmur that is not associated with an abnormal heart valve.  These types of murmurs are common in children and are due to flow of the blood through the pulmonic valve.  They are 'hum-like' in quality and disappear when the child stands up.  Whenever a medical persons asks about 'murmurs' they are asking about abnormal murmurs, not innocent murmurs.  For this reason it is not necessary to list an innocent murmur on a medical record form.

I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.

If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.

[Reg]

I just want to thank you for your explanation; clear, concise and useful as a positive supplement to the words spoken by my son's pediatrician.  Thanks again for this valuable service.

[Susan]

I don't know about that.  I was diagnosed with a functional heart murmur as a child and always dismissed it based on the same information written about above.  To make a long story short, about 14 months ago I underwent aortic valve replacement due to severe aortic stenosis caused by a congenital bicuspid valve (which is what really caused the murmur).  I did many things throughout my childhood and teens that could have been disastrous given my true condition.  I wouldn't panic certainly, but I would dismiss it either.  My diagnosis was by a pediatrician as well.  If it were my child, given my history, I would prefer a cardiologist to tell me that--for the "whatever it is worth" department.  Good luck.

[shannon]

Another "for what it's worth..."

My parents were told by our family doctor when I was six that I had an innocent murmur and that would go away as I grew.  My parents never told me about it.  When I was 25 and facing emergency surgery, my doc told me I had "a hell of a murmur" and that I should get it check out after surgery (appendectomy). In fact, he called his entire staff in to the room to listen to my heart, to help them learn about murmurs. Sure enough, I had a significant mitral prolapse and (at that time) mild mitral regurgitation.

Ultimately I did have to have mitral valve and ASD repair (March '99).  I guess I'd want to have a cardiologist's opinion, if I were you.  It may be the cardiologist advises that your child be checked every year or so, or the cardiologist might agree with your pediatrician. Whichever way it goes, at least you won't have any uncertainty.

Best of luck.

Shannon

[Reg]

I just want to thank Susan & Shannon for their "what it's worth" comments.  I guess the physicians initial words should be duly noted where he said that the "information provided . . . is for general purposes only."  Thanks again to all.

[Shannon -- to Reg]

Reg, I hope our comments help, rather than cause worry.  I have two young sons, and when my heart started to get worse, I began worrying about them.  In talking with my pediatrician, he assured me that he had never heard anything even resembling an innocent murmur over the five years he's been my kids' doctor. However, he suggested that both boys have a "rule-out" echocardiogram in their mid-teens, because several people in my immediate family have similar valve problems (so far I'm the only with the atrial septal defect).  He just felt it would be a prudent step.  

So, my point is just that I think you should take the steps that make you feel you have all of the information you need.

Best wishes to you and your family,

Shannon

[patrick]

Yes, my girlfriend was just found to have an innocent heart murmur during a routine sports physical (she says this doctor finds a lot of them)and  I wondered if she should take antibiotics before she goes to the dentist like a relative does. Do you need a stethescope to hear somebody's heart murmur? I can't hear hers with just my ear

[Peter]

I was told I have a murmur (mitrol valve prolapse) 10 years ago (43 now) and it has never bothered me that often.  This past week I have felt periodic fluttering in my chest with a related skipping of a beat.

Has anyone gone through this before?  Was curious if the irregular beat was connected to the murmur.

Thnaks

[Shannon to Peter]

Hi, Peter --

I don't know if you had any associated regurgitation when you were diagnosed with the MVP. Either way, you probably should have a check-up and, if the doc feels it's warranted, an echocardiogram.  It might be nothing, or it might be a change in your heart function.  I think the weird rhythms are often connected to MVP and/or any associated regurgitation.

Best wishes.

Shannon

[Peter]

Thanks for the response Shannon.

The odd thing is that it would bother me one day but not the next.  Yesterday and this morning it was acting up but this afternoon it's gone.

Regardless I am making an appointment.  But as it rains when you wash your car, I'm sure nothing will occur during the appointment.

Thanks again
Peter

[Shannon to Peter]

Hi, Peter -- well, I always think it's smart to check out any changes in heart stuff.  Even if it turns out to be nothing, at least you're not worrying about it.

Let us know what you find out.  I'll be interested to know if you're having PVCs or PACs related to changes in your MVP status (wouldn't it be nice if that meant most valuable player for those us with the heart stuff?)

Regards,

Shannon

[Jackie]

Reg,
I find it very interesting that a doctor would tell you not
to worry about your son's murmur.  I like Susan was also told
I had an innocent murmur.  Like Susan, my murmur was not taken
seriously until I was 43yrs old and at a very serious state.
Emergency surgery required.  Unfortunately, now my heart muscle
is damaged and I now have diastolic heart failure.  I am also told, there is no such thing as an innocent murmur.  He may be ok
now, but I'd have a cardiologist check your son annually.
Isn't it interesting that they seem to keep missing the women.
Jackie

[update]

After experiencing some palpitations recently, I am between an echocardiagram (last week) and a stress test (this week), when I received a message from the cardiologist (after reviewing my echo results) that he would like to schedule a TEE (transesophageal echiocariagram) "to get a better view."

I have questions which I will ask when I go in for the stress test this week.  But I was wondering if anyone has gone through the TEE.

It seems like a lot to go through just to "get a better look."

Thanks

[Peter]

After experiencing some palpitations recently, I am between an echocardiagram (last week) and a stress test (this week), when I received a message from the cardiologist (after reviewing my echo results) that he would like to schedule a TEE (transesophageal echiocariagram) "to get a better view."

I have questions which I will ask when I go in for the stress test this week.  But I was wondering if anyone has gone through the TEE.

It seems like a lot to go through just to "get a better look."

Thanks

[shannon]

Hi, Peter --

I had a TEE also "to get a better view."  Interestingly, though the valve was viewed easily, the docs didn't see that I had an ASD -- so I went into valve repair surgery not knowing that I had an additional problem.  All's well that ends well...they patched the hole in the atrial septum during the valve repair.

I'd guess the doctor wants to have the clearest view possible of your valve.  It's not an awful procedure, unless you have a highly developed gag reflex!  My procedure included relaxing medications (valium) and pain medication (morphine) so I was awake but feeling no pain.  It only lasted about 20 minutes.

Please let us know the results of your tests.  My email address is ***@****.  Hoping everything turns okay well --

Shannon

[shannon]

Hi, Peter --

I had a TEE also "to get a better view."  Interestingly, though the valve was viewed easily, the docs didn't see that I had an ASD -- so I went into valve repair surgery not knowing that I had an additional problem.  All's well that ends well...they patched the hole in the atrial septum during the valve repair.

I'd guess the doctor wants to have the clearest view possible of your valve.  It's not an awful procedure, unless you have a highly developed gag reflex!  My procedure included relaxing medications (valium) and pain medication (morphine) so I was awake but feeling no pain.  It only lasted about 20 minutes.

Please let us know the results of your tests.  My email address is ***@****.  Hoping everything turns okay well --

Shannon

[Peter]

After completing my TEE yesterday, the doctor wasn't to concerned with my MVP, BUT informed me that my aortic valve has only 2 parts instead of the normal three.  After 43 years, this was news.

He didn't seem too concerned, for the this being, other to say that this is something that should be checked annually!

Thanks Shannon for your input.
I'll keep you posted on any new info.

[pete]

I had my mitral valve replaced 3 years ago due to a staph infection that went undiagnosed for two weeks.  I believe that the staph infection was caused by a visit to my dentist a couple of weeks before I exhibited the first signs of feeling ill.

I had no knowledge of any family history of heart murmurs but since my surgery, I've discovered that two sisters do in fact have heart murmurs (one of whom was told that it was so faint, if the doctor had not been specifically looking for it, would not have discovered it).

Anyway, for Reg (and another for what's worth comment), I would much rather have to take a couple of pills before a trip to the dentist then what I go through now (a one-hour IV infusion of Vancomycin made at home).  Add to that a life-time of being on Coumadin and Phenobarbital (to prevent the seizures that developed due to my endocarditis).  And add to that some slight memory problems and difficulty concentrating (again, due to the damage that occured due to the seizures).

I don't want to scare anyone, but a couple of pills is far better than the alternative described above....

Good luck.