What it is
A heart murmur is an extra whooshing, humming or swishing sound heard between the usual heartbeat sounds, typically with a stethoscope. It comes from blood moving through the heart and nearby vessels. Many murmurs are described as "innocent" or "functional," meaning the heart is structurally normal.
Other murmurs are linked to something about how the heart is built or working. Possible causes include a valve that doesn't open fully or doesn't close tightly, a hole or opening between heart chambers present from birth, or changes in the heart muscle. Conditions that increase blood flow, such as fever, anemia, pregnancy or an overactive thyroid, may also make a murmur easier to hear.
Murmurs can show up in childhood or adulthood, and some come and go. A murmur by itself cannot tell anyone what is causing it. Some structural and valve conditions can run in families, so family history is often part of the conversation, and genetic heart testing is sometimes discussed in selected situations.
How it’s traditionally been approached
Traditionally, a murmur is first noticed by a primary care clinician, pediatrician or other provider listening to the heart. They may describe when it occurs in the heartbeat, how loud it is, and where it is heard best. These details can offer clues about whether it is likely innocent or worth a closer look.
If more information is needed, a clinician may recommend further evaluation. This often includes a review of personal and family history, a physical exam, and sometimes tests such as an electrocardiogram or an echocardiogram, which is an ultrasound picture of the heart. Which tests make sense is decided case by case.
Some people are simply monitored over time, while others are referred to a cardiologist. Those with valve findings may be seen by a specialist in heart valve and structural heart care, and those with muscle or pumping concerns by a heart failure and cardiomyopathy specialist. A licensed clinician decides what is appropriate after an evaluation.
How the right cardiologist may help
The right cardiologist may help by listening carefully, reviewing your history and putting the murmur in context. A visit generally includes questions about symptoms, past health, medicines and family heart history, followed by a physical exam. They may explain whether more testing is likely to be useful, or whether watching and waiting is reasonable.
If imaging or other testing is recommended, a good cardiologist may walk you through what the results show in everyday language. Where family history suggests an inherited condition, they may discuss whether genetic counseling or genetic heart testing could be considered. Genetic tests show risk or carrier status and do not diagnose heart disease on their own. They must be interpreted alongside your history, exam, imaging and bloodwork.
Questions you might bring: What is likely causing my murmur? Is it innocent or related to a valve or structure? Which tests, if any, do you recommend and why? Should I follow up over time? Could family members be affected? Is genetic counseling appropriate, and what would my insurer cover? Write down your questions beforehand so you can leave feeling informed.
The whole-person view
Body, mind and stress affect each other. Hearing that you or your child has a murmur can stir up worry, and worry can make the body feel tense, which can make ordinary sensations in the chest seem more alarming. Taking in information at a steady pace, with a trusted provider, may help.
Some people find body-based support useful for easing tension, such as the approaches offered through Somatic Experiences. Others value talking through health anxiety or uncertainty with a licensed counselor, such as through Therapists.plus. These are complements to medical care, not replacements, and every person finds their own helpful path.
Somatic Experiences: nervous system regulation →Somatic Experiences: embodiment and movement →Therapists.plus: anxiety panic and ocd →Therapists.plus: mind body connection →
Keep in mind
- This page is educational only and is not medical advice, and a murmur cannot be diagnosed or explained from a web page.
- Licensed professionals should guide any evaluation or care, and only a clinician can decide what testing or treatment is appropriate for you.
- Genetic tests show risk or carrier status, a negative result doesn't rule out risk, and a variant of uncertain significance is not a diagnosis. GINA protects against genetic discrimination in US health insurance and employment but does not cover life, disability or long-term-care insurance, so ask about those before testing. Coverage varies by insurer, state and diagnosis, so confirm with your insurer and provider.
- For emergencies such as chest pain, fainting or severe trouble breathing, call 911. In an emotional crisis, call or text 988.
Not sure where to start? Answer a few gentle questions and choose who you’d like to hear from.
Frequently asked questions
What are the most common heart murmur causes?
Common heart murmur causes include normal blood flow through a healthy heart, valve differences, openings between heart chambers present from birth, and conditions that increase blood flow such as fever, anemia or pregnancy. Which applies depends on the person. A clinician can help work out the cause after an evaluation.
Is a heart murmur always serious?
No, many murmurs are innocent and happen in a structurally normal heart. Others are linked to valve or structural differences that a cardiologist may want to follow. Only a licensed clinician can tell which kind you have.
Can a heart murmur go away?
Yes, some murmurs, especially those related to growth, fever, pregnancy or other temporary conditions, may fade or disappear. Others stay the same for years. Ask your clinician whether follow-up makes sense for you.
How is a heart murmur evaluated?
A murmur is usually evaluated by listening to the heart and reviewing your symptoms and personal and family history. A clinician may then suggest tests such as an electrocardiogram or echocardiogram if more detail is needed. The choice of tests is made individually.
Can heart murmur causes be genetic?
Sometimes, because certain valve and heart muscle conditions can run in families. Genetic heart testing may be discussed in selected cases, but it shows risk or carrier status and does not diagnose disease on its own. A cardiologist or genetic counselor can help interpret any results, and a negative result doesn't rule out risk.
What kind of doctor should I see about a heart murmur?
A primary care clinician or pediatrician often notices a murmur first and may refer you to a cardiologist. Depending on the findings, you might see a specialist in heart valve and structural heart care or in heart failure and cardiomyopathy. Ask your provider which type of specialist fits your situation.
Educational resource. CardioGenes shares general information and connects people with independent cardiologists. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health.