To define it, heart murmurs are abnormal sounds heard during examination with examination instruments called stethoscope and heart listening. However, some diagnoses can be made with detailed information such as the intensity and quality of these sounds. Not every heart murmur is a sign of illness, and there can be heart disease without a murmur. A murmur is heard during examination in many congenital or acquired diseases in childhood heart disease. Although heart murmurs can be a finding that is actually called an innocent murmur without any sign of illness, sometimes they can be one of the first symptoms of a major illness. For this reason, it would be appropriate to evaluate heart murmurs in two separate groups to be understandable: 1. Innocent murmurs: To detect such sounds, the intensity of the sounds heard can be determined by the timing and whether they increase with different factors . These sounds are not a symptom of heart disease, but they sometimes occur physiologically, and sometimes they can be heard through various mechanisms caused by non-cardiac disease. 2. Pathological or disease-related heart murmurs: This kind of murmur occurs during diseases related to intracardiac structures, valves or diseases of the great vessels.
The most common serious diseases are heart holes (such as VSD, ASD, PDA, AVSD), valvular heart disease (such as valvular stenosis or insufficiency), and large vessel diseases (such as congenital vascular anomalies or stenosis). Today, it is preferable to make the correct diagnosis by conducting further investigations after detecting a heart murmur. For this purpose, the most commonly used diagnostic tools are tests such as ECG and echocardiography that do not cause any side effects for the patient. Pediatricians’ research findings are helpful in deciding which patients require further investigation. The severity of heart murmurs sometimes increases proportionally with disease, and sometimes the loud noise can be associated with mild disease (such as a small VSD hole). At this point it can be interpreted that it is not correct to determine the severity of the disease with the sound or murmur heard in the heart. For this reason, ultrasound methods called echocardiography are commonly used. After this evaluation, a definitive diagnosis can be made.
The most important thing to know and remember about heart murmurs and other heart sounds is that the absence of a heart murmur does not mean there is no heart disease. Some diseases are known to progress silently without a heart murmur. In some cases, when the heart murmur is heard, the disease has progressed and the likelihood of response to treatment is reduced. Prof. Dr. Ayhan Çevik, ”In our children with heart murmurs, it is recommended to determine whether these sounds are primarily a sign of illness or an indicator of a physiological state, and to use diagnostic tools such as echocardiography if necessary. Depending on the assessment by paediatricians, the necessary further investigations can be carried out: if the heart sounds and murmurs are of a harmless nature, that is, they are not signs of illness, continuous follow-up and check-ups are not required. The treatment of murmurs due to diseases is done by treating the cause of these abnormal sounds.