Bbw4doc in this day and age where patients take a more proactive role with regards to maintaining a healthy life, I see absolutely nothing wrong in saying that you are aware that you have a heart murmur and use a stethoscope to evaluate it .
Now as you said
*I*, an untrained person, can hear it. My GP cannot. She said she doesn't hear any "significant" murmur.
The key word here is "significant" . Normal blood flow across the valve usually does not cause a noise (murmur).” Most murmurs are functional, or physiologic, and are normal variants. Many heart murmurs are harmless and referred to as innocent or functional. There may be an underlying medical condition that can lead to an innocent murmur. These may include situations where the heart beats more quickly such as fever, anemia, hyperthyroidism, and pregnancy.
Congenital heart murmurs are heard in the newborn. They may be due to abnormalities in the valves, septae, or arteries, and veins that carry blood to and from the heart. In some complicated heart disease conditions there may be a combination of all three. Many congenital heart murmurs resolve spontaneously without medical intervention while others require surgical operations for repair.
Abnormalities of the valves of the heart may cause a heart murmur. Any of the heart valves may be affected and clinical symptoms depend upon the severity of the valve damage and whether the blood flow pattern within the heart is maintained. Each valve problem often leads to a specific character and timing of heart murmur.
- Valve stenosis is narrowing of a heart valve. This often occurs over time as the valve scars due to injury and scarring from infection such as in rheumatic fever or from a congenital birth defect. Calcification of a valve may also result in stenosis. This causes the heart muscle to work harder to push blood through the narrowed opening. Like any muscle that has to work harder, heart muscle will hypertrophy and thicken. Heart failure, where fluid builds up in the lungs and extremeties, may be a complication.
- Valve regurgitation (or insufficiency) is a valve that leaks causing blood to pass backward against the normal blood flow pattern in the heart. A valve may have both stenosis and regurgitation.
- Valve sclerosis is the mild narrowing and stiffening of the valve (most often seen in the aortic valve) due to aging. It is associated with atherosclerotic heart disease.
- Valve prolapse is a bowing of a valve that causes some leaking and most often involves the mitral valve.
- Endocarditis is an infection of the lining of the heart that may involve and destroy a heart valve. The source of the infection is usually elsewhere in the body and it travels via the bloodstream to infect the heart. There may be a previous underlying heart condition.
Holes in the walls of the heart (the septum that divides the heart chambers) can be the source of a heart murmur. Atrial septal defect (ASD) describes a hole in the wall that separates the collecting chamber of the heart while a ventricular septal defect (VSD) affects the wall dividing the pumping chamber.
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What are the risk factors for heart murmur?
A heart murmur is a physical finding of an underlying heart condition and in many instances may be of no consequence. The risk factor for developing a particular murmur is the risk factor for the underlying condition.
Congenital heart disease tends to have a familial basis, meaning that there may be a genetic predisposition for a baby to develop a structurally abnormal heart.
Some valvular diseases are present at birth, but take a lifetime to develop symptoms. For example, the aortic valve is supposed to have three leaflets that come together; some people are born with a valve that has only two leaflets (bicuspid). Over time, a two-leafed valve may be more prone to calcification and narrowing. Symptoms may only be seen later in life.
Some valve diseases are due to infection (endocarditis). Historically, rheumatic fever described heart valve inflammation as a consequence of a bacterial streptococcus infection. With present day screening for strep infections and the appropriate use of antibiotics, this rheumatic heart disease is rare. Endocarditis may be seen as a complication of intravenous drug abuse.
Other risk factors for heart valve abnormalities include atherosclerotic heart disease, heart attack, aortic aneurysm, and connective tissue disorders such as systemic lupus erythematosus and Marfan syndrome. Each condition affects the valves in a different way causing them to malfunction and develop the physical finding of a heart murmur.