Testing for and Classifying Heart Murmurs

Classifying a Heart Murmur After Diagnosis

Healthcare providers classify murmurs as:
  • Systolic: A systolic murmur is heard when the heart is squeezing and pumping blood out of the heart.
  • Diastolic: A diastolic murmur is heard when the heart is relaxing and filling with blood. Diastolic murmurs are often a sign of a heart defect or heart disease and should be further evaluated.
  • Continuous: Continuous murmurs are heard during the entire heartbeat. These are often a sign of a heart defect or heart disease and should be further evaluated.

Tests and Procedures Used to Diagnose a Heart Murmur

When healthcare providers hear a murmur that might be abnormal, they may order the following tests:
  • Chest x-ray: A chest x-ray is a picture of the heart and lungs. It can show if the heart is enlarged and whether certain problems of the heart and lungs are present.
  • Electrocardiogram (ECG): This test is used to measure the rate and regularity of a person's heartbeat. The ECG can help rule out a variety of heart problems.
Based on the results of these initial tests, a heart specialist will most likely do any follow-up testing. These tests might include:
  • Echocardiogram: An echocardiogram uses ultrasound (sound waves) to allow doctors to view the heart as it pumps and relaxes. The echocardiogram is more detailed than an x-ray image and shows the structure and function of the heart.
In some cases, transesophageal echocardiography (TEE) might be needed to get a better view of the heart. In TEE, the doctor inserts an ultrasound probe down the throat into the esophagus after the person is sedated.
  • Cardiac catheterization and angiography: Cardiac catheterization is a procedure in which a catheter (a thin flexible tube) is passed through an artery or vein at the top of the leg (groin) or in the arm to reach the heart. The person is sedated for this procedure.
Cardiac catheterization allows the pressure inside the heart and blood vessels to be measured. Angiography involves injecting a dye that can be seen using x-ray. This helps the doctor see the flow of blood through the heart and blood vessels.
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Information on Heart Murmurs

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