Dr Yang Linqi from Thomson Paediatric Centre tells parents about what they should be aware of
When it comes to your little one, the words “heart murmurs” are enough to cause worry and anxiety in any parent. But what exactly defines a heart murmur, and is it always a big cause of concern?
“Heart murmurs are essentially extra sounds that we hear through a stethoscope when we listen to a person's heartbeat,” says Dr Yang Linqi, a paediatrician at Thomson Paediatric Centre who specialises in paediatric cardiology.
A normal heartbeat typically consists of 2 sounds: "lub-dup". These sounds are made when the heart valves close inside the heart. “Murmurs are swishing sounds that are made by turbulent blood flow within the heart and its blood vessels,” Dr Yang says.
How common are heart murmurs?
As Dr Yang shares, it is rather common for babies to have heart murmurs when they are born. “Many changes happen to the heart and its pumping system when a baby is born, and these include closure of a blood vessel,” she explains. “As this vessel closes, turbulent flow across it can cause a murmur.”
Another common reason for a murmur to be heard in a newborn is the increased lung pressure in the newly opened lungs of a baby. “This can lead to a mild backflow of blood through the valve (known as tricuspid regurgitation), or an increase in flow pressure in the lung artery (pulmonary stenosis),” Dr Yang adds. She also reassures that these murmurs often resolve spontaneously as a child develops and grows.
When should I worry about a baby’s heart murmur?
Dr Yang notes that heart murmurs can be normal, often called innocent murmurs, or they may be a sign of a heart condition − such as an abnormal heart valve or a hole in the heart. As such, it is important to perform tests to investigate for a cause. “Heart murmurs in a young child are always treated with urgency as a child is usually unable to express their symptoms well,” says Dr Yang.
The most immediate test would be a 2D echocardiogram (an ultrasound scan) that can be performed at the bedside or in a clinic, to determine the exact cause of the murmur. “This ultrasound scan examines the structure and function of the heart, its valves and vessels,” elaborates Dr Yang.
Other tests include blood pressure and oxygen saturation measurements, which can help to determine the severity of the heart conditions. The treatment then depends on the cause. Often, the murmur is due to a mild condition and the child may only require regular monitoring.
In some cases, the murmurs are normal (innocent) and no further intervention or monitoring is needed. In uncommon cases, the murmur may be diagnosed to be due to a more severe or complicated heart condition. This may require medications or surgical treatment.
What are the signs and symptoms of heart conditions in babies?
Heart murmurs are one of the most common signs of heart diseases in babies.
Other signs and symptoms would include:
- Blueness of the lips and tongue (cyanosis)
- Pallor (an unhealthy pale appearance)
- Breathlessness and increased effort of breathing
- Poor weight gain
- Difficulty in feeding
- Cold sweats
- Irritability
- Lethargy
Is treatment required for babies with heart murmurs?
Treatment options would vary widely depending on the cause of the murmur. “Oral medications such as diuretics may be used in some cases to decrease the load on the heart in children with large holes in the heart,” says Dr Yang.
Injection medications may be required to help close persistently patent ductus arteriosus (a persistent opening between the two major blood vessels leading from the heart). In cases of significant structural heart defects, transcatheter or surgical treatment may be necessary.
“Discussion with the child's cardiologist and cardiac surgeon would be most important to determine the best route of treatment for the individual child,” Dr Yang advises.
Where can I seek help for my child’s heart murmur or heart condition?
If you're concerned about a heart murmur in your baby or if they are exhibiting signs of a heart condition, make an appointment with a paediatrician.
Thomson Paediatric Centre offers medical care for children of varying ages, from newborns to infants, children and adolescents. They also specialise in paediatric cardiology, focusing on heart-related conditions in infants and children.
Infants with heart conditions require special attention immediately upon diagnosis. Your paediatric cardiologist will assess the situation, and provide the appropriate treatments to ensure your child's well-being beyond infancy.
Thomson Paediatric Centre
339 Thomson Road, #03-06, SIngapore 307677
Phone: 6258 3353
Email: tpc@thomsonmedical.com
Website: https://thomsonpaediatriccentre.com/
Photos: iStock
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