Heart disease

How is a child's heart murmur diagnosed?


The term 'heart murmur' is often worrisome to parents. However, it is important to know how to face it with serenity and optimism until the conclusion of the complementary tests, which determine the character of the child's murmur.

It may be a physiological, functional and therefore temporary murmur that will allow the child to lead a normal life, without restrictions in their physical activity or cardiological supervision. If, on the other hand, it is an organic murmur, it is best to put the child in the hands of a cardiologist.

The murmur is heard when the child is listened to with a stethoscope, which is supported in different areas of the chest, while the heart beats. Heart murmurs can be heard in babies, older children, or teenagers. Some heart murmurs can indicate a problem with the heart.

If the pediatrician suspects that the child may have something more important than a functional murmur, he will refer him to a pediatric cardiologist, who will order some additional tests, such as a chest x-ray, a ECG (electrocardiogram) or a echocardiogram.

The echocardiogram, or "echo", is an ultrasound of the structures of the heart (cavities, walls and valves), which records the circulation of blood through the heart and allows to determine the direction and speed of blood flow within the structures cardiac.

Heart murmurs are classified into a intensity scale from 1 to 6 depending on its volume. Grade 1 can barely be heard, while grade 6 is very loud. To assess it accurately, the pediatrician must determine in which part of the heart the murmur is best heard, what its characteristics are (that is, if it is discordant and high or soft and similar to a murmur), at what point in the cardiac cycle it occurs , and if it is modified when the child changes position. It is common for the pediatrician to refer the child to a pediatric cardiologist for a new evaluation.

They are murmurs or noises that are heard in the heart during a routine check-up. Functional murmurs usually come and go, depending on the child's heart rate, the position he takes during the exam, and the presence of fever.

Congenital heart disease is present from birth and represents a type of heart problem or abnormality that can occur with a murmur. Some are not serious enough at first to produce a murmur that can be detected during the exam.

The heart has four chambers and four valves, which function as one-way doors. The two lower chambers of the heart, which pump blood, are called the ventricles, and the two upper chambers, which fill with blood, are the atria.

When blood circulation is normal, the blood returning from the body is low in oxygen and goes to the right filling chamber or right atrium. This blood passes through a valve (the tricuspid valve) into the right pumping chamber (the right ventricle) and then travels through the pulmonary valve into the lungs to receive oxygen.

This oxygen-enriched blood returns to the left filling chamber (the left atrium) and through a valve (the mitral valve) passes into the left pumping chamber (the left ventricle). The blood is then pumped through the aortic valve throughout the body through the aorta, a large blood vessel that carries blood to the body's smallest blood vessels to deliver oxygen to them.

The sound of a normal heartbeat is a product of the valves closing as the heart contracts to push blood through the body. When there is a heart murmur, an extra sound is produced, which can be heard thanks to a stethoscope, which is used by the doctor to assess its condition. Sometimes these extra sounds are just the result of normal blood flow, circulating through a normal heart. In other cases, a murmur can indicate a heart problem.

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