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There are two types are heart murmurs: innocent murmurs and abnormal murmurs. A person with an innocent murmur has a normal heart. This type of heart murmur is common in newborns and children. More than half of all children have heart murmurs at some time, and most of those murmurs are harmless.

An abnormal heart murmur is more serious. In children, abnormal murmurs are usually caused by congenital heart disease. In adults, abnormal murmurs are most often due to acquired heart valve problems.

Innocent heart murmurs
An innocent murmur can occur when blood flows more rapidly through the heart. Conditions that may cause rapid blood flow through your heart, resulting in an innocent heart murmur, are:

1.An excessive amount of thyroid hormone in your body (hyperthyroidism).
2.Not having enough healthy red blood cells to carry adequate oxygen to your body tissues (anemia).
3.Changes in your heart’s structure, such as changes from heart surgery.
4.Fever
5.Pregnancy
6.Physical activity or exercise

Changes to the heart due to aging or heart surgery also may cause an innocent heart murmur. Innocent heart murmurs may disappear over time, or they may last your entire life without ever causing further health problems.

Abnormal heart murmurs
Although most heart murmurs aren’t serious, some may result from a heart problem. The most common cause of abnormal murmurs in children is congenital heart disease — when babies are born with structural heart defects. Common congenital defects that cause heart murmurs include:

Heart valve abnormalities:Congenital heart valve abnormalities are present at birth, but sometimes aren’t discovered until much later in life. Examples include valves that don’t allow enough blood through them (stenosis) or those that don’t close properly and leak (regurgitation).

Holes in the heart or cardiac shunts: Many heart murmurs in children are the result of holes in the walls between heart chambers, known as septal defects. These may or may not be serious, depending on the size of the hole and its location. Shunts occur when there’s an abnormal blood flow between the heart chambers or blood vessels, leading to a heart murmur.

Functional heart murmur:Many heart murmurs are harmless and referred to as innocent or functional. They are caused when blood rushes through the heart quickly during normal function while no heart disease may exist. There may be an underlying medical condition that can lead to an innocent murmur. These may include situations where the heart beats more quickly such as fever, anemia, hyperthyroidism, and pregnancy.

Congenital heart murmurs:Congenital heart murmurs are heard in the newborn. They may be due to abnormalities in the valves, septae or arteries, and veins that carry blood to and from the heart. In some complicated heart disease conditions there may be a combination of all three. Many congenital heart murmurs resolve spontaneously without medical intervention while others require surgical operations for repair.

Patent ductus arteriosus (PDA) may cause a heart murmur in a newborn. Prior to birth birth, the aorta and pulmonary artery are connected by a small artery, the ductus arteriosus, to complete fetal blood circulation. Shortly after birth, this artery is supposed to close. If other congenital heart abnormalities exist, the ductus may remain open to help maintain some blood circulation. Sometimes, when no congenital abnormalities exist, the ductus doesn’t completely close and a murmur may exist. Many times the patent ductus arteriosus closes by itself over time. Occasionally, medications or surgery may be required to close off the patent ductus arteriosus.

Valve abnormalities:Abnormalities of the valves of the heart may cause a heart murmur. Any of the heart valves may be affected and clinical symptoms depend upon the severity of the valve damage and whether the blood flow pattern within the heart is maintained. Each valve problem often leads to a specific character and timing of heart murmur.

Valve stenosis is narrowing of a heart valve: This often occurs over time as the valve scars due to injury and scarring from infection such as in rheumatic fever or from a congenital birth defect. Calcification of a valve may also result in stenosis. This causes the heart muscle to work harder to push blood through the narrowed opening and possible heart failure.

Valve regurgitation (or insufficiency) is a valve that leaks causing blood to pass backward against the normal blood flow pattern in the heart. A valve may have both stenosis and regurgitation.

Valve sclerosis is the mild narrowing and stiffening of the valve (most often seen in the aortic valve) due to aging. It is associated with atherosclerotic heart disease.

Valve prolapse is a bowing of a valve that causes some leaking and most often involves the mitral valve.

Endocarditis is an infection of the lining of the heart that may involve and destroy a heart valve. The source of the infection is usually elsewhere in the body and it travels via the bloodstream to infect the heart. Most often, there is a previous underlying heart condition.

Holes in the walls of the heart (the septum that divides the heart chambers) can be the source of a heart murmur. Atrial septal defect (ASD) describes a hole in the wall that separates the collecting chamber of the heart while a ventricular septal defect (VSD) affects the wall dividing the pumping chamber.

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