‘Rapid heart rate should not be neglected in a child with murmurs’

Pediatric Cardiology Specialist Assoc. Dr. Fikri Demir made statements about the murmur in infants and children. Pediatric Cardiology Specialist Assoc. Dr Fikri Demir said: “A murmur can be heard in about 30-40 per cent of children of all ages, from newborn to age 18. It is mainly seen in the preschool period,” he said.


associate Dr. Demir explained the causes of the murmur as follows:

“Our heart is our most active organ. It pumps blood to our body by contracting regularly. In children with congenital or acquired heart disease, blood flow paths and flow rate change depending on heart holes and valve disease. As a result, pathological (abnormal) murmurs occur due to the pressure difference between the heart chambers. In some healthy children, a slight murmur may also be heard due to blood flow through the muscle fibers during the pumping action of the heart. In cases such as fever, anemia, and excess thyroid hormones, the intensity of the murmur increases and becomes easier to hear.

MOST murmurs can be harmless

Emphasizing that the murmur is not heart disease, but a sound caused by the disease (research finding), Assoc. Dr Demir said: “A murmur is heard in congenital heart diseases such as VSD, ASD, PDA, tetralogy of Fallot, and acquired heart diseases such as rheumatic heart disease, mitral valve prolapse, valvular insufficiency. However, most children with murmurs have a normal heart exam. murmurs of these children, who heard a murmur but were found to be normal on examination, are called harmless murmurs.


associate Dr. Demir shared the following information about the symptoms seen in murmurs:

“Symptoms vary depending on the disease causing the murmur. In children with heart disease and its associated murmur, rapid heartbeat, feeling the heartbeat easily with our hands, rapid breathing, difficulty breathing, wheezing, fatigue when sucking, prolonged inactivity can suck, especially cold sweat on the forehead, swelling of the eyelids and buttocks, not enough Symptoms such as inability to gain weight, frequent lung infections, chest pain, bruising and fainting may be observed due to the inability to absorb and energy expenditure. If these findings are present, families should apply to pediatric cardiology specialists without wasting time. However, murmurs can also be detected in healthy children. Most healthy children with additional murmurs do not have heart complaints. These children are usually referred to pediatric cardiologists because during the investigation for non-car for some reason a murmur can be heard. It should be remembered that heart disease can rarely be detected in children who show no symptoms and do not hear murmurs when listening.


Speaking of the diagnosis process, Assoc. Dr. Demir: “Whether the child has other complaints besides the murmur, such as fatigue, shortness of breath and bruises; It gives an idea about the severity of the murmur and whether the murmur heard in the heart region is harmless or a disease-related murmur. The precise distinction between innocent and disease-related murmurs is made by echocardiography (ECHO), which can be described as cardiac ultrasound performed by pediatric cardiology specialists. Echocardiography also allows us to understand from which disease the abnormal murmur comes. We sometimes use cardiac catheterization and angiography in the diagnosis and treatment of complex congenital heart defects.


Explain what noise can be dangerous, Assoc. Dr Demir said:

‘Here it would be correct to talk about the danger of the disease causing the murmur instead of the murmur. Most congenital and acquired heart conditions can be treated today. However, it can be said that some of the cyanotic congenital heart conditions that progress with severe bruising and cause heart failure or significant arrhythmias such as complete AV block are more dangerous. Hypoplastic left heart syndrome, which is characterized by the smallness of the heart’s left ventricle and aorta, congenital heart disease requiring repair of one ventricle, and transposition, which is characterized by the inversion of the great vessels exiting the heart, are some of the these diseases. However, congenital heart disease, which is relatively easy to treat, is not noticed in the first days of life and can be dangerous if it leads to a deterioration in the child’s general condition or if the vascular connections created by surgery to increase blood flow , are blocked . Examples of these conditions are aortic atresia, pulmonary atresia and critical aortic coarctation, which are characterized by the absence of heart valves or vascular stenosis.”


Recalling that murmurs without heart disease are generally harmless murmurs and do not require treatment, Assoc. Dr Demir said: “Minor heart holes such as VSD and ASD, which cause a murmur but do not tire the heart, and mild valvular stenosis and insufficiency require no treatment. In the remaining children, treatment varies depending on the disease causing the murmur. diseases that cause heart failure are given medications that reduce the afterload of the heart and diuretics to try to control heart failure Valve stenosis and heart holes that require corrective treatment are treated with a transcatheter (insertion of the aortic valve into the heart using the catheter method without open-heart surgery), without surgery, if possible via the groin, otherwise surgical. Valve deficiencies requiring treatment of complex congenital diseases are treated with open-heart surgery. Some patients may require taping or shunt surgery before undergoing corrective treatment,” he concluded.

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