A Murmur Is a Finding
Hearing that your child has a heart murmur can be unsettling. In many children, a murmur is an innocent sound made by blood flowing through a healthy heart. The sound alone is not a diagnosis of heart disease, and a clinician must assess it in context.
A healthcare professional will consider the child’s health history, symptoms, and examination findings when deciding whether follow-up or tests are needed. Some children need no treatment, while others may benefit from further evaluation by a pediatric cardiologist. Children’s Hospital of Philadelphia explains how clinicians assess a child’s murmur.
This article explains what murmurs sound like, why they occur, and which signs families should notice. It also covers when to contact your child’s pediatrician and when symptoms call for emergency help. For families in Federal Way, federalwaypediatrics.com provides pediatric and pediatric cardiology care focused on infants, children, and adolescents.
What Heart Murmurs Sound Like
A heart murmur is an extra or unusual sound heard as blood flows through the heart. It is a finding, not a diagnosis: the sound alone does not show whether a child has heart disease. A clinician listens with a stethoscope and considers the sound alongside the child’s health and examination. For a plain-language overview of what a heart murmur sounds like, see our related guide.
Many children have innocent, or functional, murmurs even though their hearts are healthy. These murmurs usually cause no symptoms beyond the sound, need no treatment, and may fade as a child grows. Other murmurs may be associated with a congenital heart defect or another underlying condition, but an unusual sound does not automatically mean there is a problem. Johns Hopkins Medicine’s overview of heart murmurs in children explains that clinicians assess the sound and the child together.
Clinicians describe a murmur partly by when it occurs in the heartbeat. A systolic murmur is heard as the heart contracts, a diastolic murmur as it relaxes, and a continuous murmur throughout the heartbeat. They may also grade loudness on a scale from 1 to 6. Timing and loudness help guide assessment, but neither determines the cause or seriousness on its own.
At federalwaypediatrics.com, pediatric care includes an emphasis on pediatric cardiology, so families can discuss a murmur in the context of their child’s health. The clinician can explain what the sound suggests and whether further assessment is appropriate.
Why Murmurs Develop
Many childhood murmurs occur as blood moves through a healthy heart, without any structural abnormality. These are often called innocent murmurs. They are a sound heard during an examination, not a diagnosis of heart disease. Read more about why innocent murmurs may occur in children.
Other murmurs can be associated with a congenital heart defect or heart valve disease. Infection, fever, anemia, and an overactive thyroid may also contribute to a murmur. These possibilities do not mean a child has a specific condition; a healthcare professional considers the child’s health history, symptoms, and examination findings. Johns Hopkins Medicine explains possible causes of heart murmurs in children.
Fever or illness can change blood flow and make some murmurs easier to hear, and activity or excitement may also affect how noticeable the sound is. An innocent murmur may become less noticeable after a child recovers. A change in loudness alone cannot show whether a heart problem is present.
A clinician assesses the murmur alongside the child’s overall health and examination to decide whether further evaluation is appropriate. At federalwaypediatrics.com, pediatric care includes assessment of children’s heart concerns, with specialist evaluation available when the clinical findings call for it.
How Clinicians Assess a Murmur
A clinician starts by asking about the child’s health, symptoms, and medical history, then listens to the heart with a stethoscope. The sound is considered alongside the child’s overall examination and health, rather than judged in isolation.
An innocent murmur occurs in a child with a healthy heart and generally causes no symptoms beyond the sound. A murmur may need closer evaluation if the child’s history, symptoms, or examination raise concern. Loudness alone cannot show whether a murmur is harmless or related to a heart problem, as Johns Hopkins Medicine explains.
If the sound is unusual or other findings are concerning, the provider may recommend assessment by a pediatric cardiologist. A pediatric cardiology evaluation can combine the child’s history and physical examination with tests selected for the individual situation. The Children’s Hospital of Philadelphia guide to heart murmurs notes that not every child needs every test, and families should follow through when a specialist referral is recommended.
Possible tests include a chest X-ray, which images the heart and lungs; an electrocardiogram (ECG), which records the heart’s electrical activity; and an echocardiogram (echo), which uses ultrasound to examine heart structure and function. Johns Hopkins identifies echocardiography as the most important test for evaluating a murmur, but the provider determines whether it or any other test is appropriate.
At Federal Way Pediatrics, pediatric care includes a focus on pediatric cardiology in Federal Way, Washington, giving families a local setting to discuss a murmur and the next steps in their child’s care.
Signs Families Should Notice
Many children with an innocent murmur have no symptoms beyond the sound a clinician hears during an examination. A murmur alone does not mean a child has heart disease, and the absence of symptoms does not replace a clinician’s assessment.
In babies, signs that may warrant a call to the healthcare provider include difficulty feeding, sweating during feeds, rapid or difficult breathing, or poor weight gain and growth. Families can note when these signs occur and share what they observe during an appointment. The Johns Hopkins Medicine overview of heart murmurs in children describes these as possible symptoms associated with an underlying condition.
Older children may tire unusually easily or have difficulty keeping up with exercise. Other possible signs include chest pain, dizziness or fainting, and bluish lips or fingertips. Some underlying conditions can also cause a cough or swelling in the legs, feet, abdomen, liver, or neck veins. These symptoms are not specific to heart disease, and some children with heart conditions may not show obvious signs.
At federalwaypediatrics.com, pediatric care includes assessment of children’s heart concerns, with care tailored to each child’s findings. Symptoms alone cannot identify the cause of a murmur, so contact your child’s healthcare provider rather than trying to diagnose it at home. For more context on signs families may notice, see guidance on recognizing possible red flags.
When to Contact a Provider
Arrange an assessment with your child’s pediatrician when a heart murmur is newly noticed. Many childhood murmurs are harmless, but the sound alone cannot show whether further evaluation is needed. The clinician can review your child’s health and symptom history, examine them, and decide whether monitoring, testing, or a pediatric cardiology consultation is appropriate. Johns Hopkins Medicine explains how clinicians evaluate heart murmurs in children.
Contact your child’s healthcare provider promptly if you notice feeding difficulty, inadequate weight gain, unusual tiredness, trouble keeping up with activity, or faintness. Also report breathing problems, chest pain, dizziness or fainting, bluish coloring of the lips, fingertips, legs, or feet, and swelling in the legs, feet, or abdomen. These signs can have causes other than heart disease, so a clinician should assess them rather than relying on symptoms alone.
Do not wait for a routine appointment if severe warning signs occur. Call 911 for chest pain, rapid or irregular breathing, blue lips, loss of consciousness, or unresponsiveness. For guidance on arranging a non-emergency assessment, read about when to seek care for a child’s heart murmur.
Treatment Depends on the Cause
Treatment is guided by what is causing the murmur, not by the sound alone. When a clinician confirms that a murmur is innocent, it does not require medicine or other treatment, and some innocent murmurs fade as a child grows. Johns Hopkins Medicine explains that innocent murmurs occur in children with healthy hearts and may disappear over time.
An innocent murmur does not automatically mean a child needs activity restrictions. Families can ask the child’s provider whether any limits or follow-up are appropriate for that child’s findings. For more on why these murmurs usually do not need treatment, see this guide to common pediatric heart murmurs.
If a murmur is linked to a congenital heart defect, care may include medicine, a procedure, or surgery, depending on the specific problem. When another condition, such as fever or anemia, is contributing to the murmur, treating that condition may make the sound lessen or go away. A pediatric cardiology assessment at federalwaypediatrics.com can help families understand the findings and discuss appropriate next steps.
The murmur itself does not cause complications; risks come from an underlying condition. Some congenital heart defects can affect a child’s growth and development or lead to heart failure and other serious problems. This does not mean that every murmur signals a defect, but it is worth following the clinician’s recommendations for evaluation and care.
Can an innocent heart murmur become dangerous or require treatment? An innocent murmur is not itself a dangerous heart condition and generally needs no treatment. If it has not been evaluated, changes, or occurs with fainting, chest pain, unusual shortness of breath, or poor growth, contact the child’s pediatrician. A clinician can decide whether further assessment is needed.
Partner With Your Child’s Care Team
Many childhood murmurs are innocent, but the sound alone cannot determine the cause. A healthcare professional can assess your child’s history and examination findings and decide whether further evaluation is needed.
Share your concerns and any symptoms with your child’s pediatrician, including changes in feeding, breathing, energy, or exercise tolerance. If the clinician recommends a pediatric cardiology referral, follow through so a specialist can assess your child and discuss next steps. Children’s Hospital of Philadelphia’s guidance on heart murmurs explains that testing is based on each child’s findings.
For a child with chest pain, rapid or irregular breathing, blue lips, or loss of consciousness or unresponsiveness, call 911. These symptoms need emergency attention.
