Heart Murmur Diagnosis

Diagnosing a heart murmur starts with carefully listening to the patient's heartbeat with a stethescope. If a heart murmur is heard, the doctor will classify it as systolic, diastolic, or continuous. Tests, such as a chest x-ray or an electrocardiogram (ECG), can be helpful in making a heart murmur diagnosis. Further testing by a cardiologist may also be necessary.

 
 

Heart Murmur Diagnosis: An Overview

Doctors use a stethoscope to listen to heart sounds and hear murmurs. They often notice innocent heart murmurs during routine checkups or physical exams. Abnormal murmurs may also be heard during routine checkups.
 
Murmurs caused by congenital heart disease are often heard at birth or during infancy. However, murmurs caused by other heart problems may be discovered at any age.
 
Doctors usually refer people with abnormal murmurs to a heart specialist (a pediatric cardiologist or a cardiologist) for further evaluation and testing.
 

Heart Murmur Diagnosis: Medical History and Physical Examination

Doctors listen carefully to the heart with a stethoscope to help decide if a murmur is innocent or abnormal. They listen to the loudness, location, and timing of the murmur in order to classify and describe the sound. This helps the doctor begin to diagnose the cause of the murmur.
 
The doctor also:
 
  • Takes a medical and family history
     
  • Does a complete physical exam, looking for signs of illness or physical problems (such as blue coloring of the skin, delayed growth, and feeding problems in an infant)
     
  • Asks about symptoms such as chest pain, shortness of breath (especially with exercise), dizziness, or fainting.
     
When evaluating a heart murmur, the doctor pays attention to a number of things, including:
 
  • How faint or loud the sound is -- the doctor grades the murmur on a scale of 1 to 6 (1 is very faint and 6 is very loud)
     
  • When the sound occurs in the cycle of the heartbeat
     
  • Exactly where the sound is heard in the chest and whether it can also be heard in the neck or back
     
  • Whether the sound has a high, medium, or low pitch
     
  • How long the sound lasts
     
  • How breathing, exercise, or change of body position affects the sound.
     
(Heart Murmur Diagnosis Continued: Page 2)
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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD