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Doctors use a stethoscope to listen to heart sounds and hear murmurs. They often notice innocent heart murmurs during routine checkups or physical exams. Abnormal murmurs may also be heard during routine checkups.

Murmurs caused by congenital heart disease are often heard at birth or during infancy. However, murmurs caused by other heart problems may be discovered at any age.

Doctors usually refer people with abnormal murmurs to a heart specialist (a pediatric cardiologist or a cardiologist) for further evaluation and testing.

Heart Murmurs Tests and Diagnosis

Electrocardiogram (ECG). In this noninvasive test, a technician will place probes on your chest that record the electrical impulses that make your heart beat. An ECG records these electrical signals and can help your doctor look for heart rhythm and structure problems.

Chest X-ray: A chest X-ray shows an image of your heart, lungs and blood vessels. It can reveal if your heart is enlarged, which may mean an underlying condition is causing your heart murmur.

Electrocardiogram:Electrocardiogram (ECG or EKG) to determine the rate and regularity of the heartbeat. The ECG is administered with wires attached to the patient’s body. The wires detect electrical signals from the heart, which are recorded on a machine for the doctor’s review.

Echocardiograph:Echocardiograph (ECHO) to identify areas of the heart that are contracting irregularly. The ECHO uses sound waves to create pictures of the heart.

Angiography:Angiography, or cardiac catheterization, to determine the pressure on the heart and the blood vessels feeding it.

Stress Test:Stress test is an ECG administered to evaluate the rate regularity of the heartbeat during activity.

Physical Exam:Physical exam with a stethoscope to detect the loudness, location, pitch and length of the murmur.

Transthoracic or transesophageal echocardiogram. This noninvasive exam, which includes an ultrasound of your chest, shows detailed images of your heart’s structure and function. Ultrasound waves are transmitted, and their echoes are recorded with a device called a transducer that’s held outside your body. A computer uses the information from the transducer to create moving images on a video monitor. This test identifies abnormal heart valves, such as those that are hardened (calcified) or leaking, and can also detect most heart defects.

If the images from a transthoracic echocardiogram are unclear, the doctor may recommend a transesophageal ultrasound. During this exam, a flexible tube containing a small transducer about the size of your index finger is guided down your throat. The transducer will transmit images of your heart to a computer monitor. Since the esophagus passes close behind your heart, the transesophageal transducer can produce better images than can sound waves transmitted through your chest.

Cardiac catheterization. In this test, a short tube (sheath) is inserted into a vein or artery at the top of your leg (groin) or arm. A hollow, flexible and longer tube (guide catheter) is then inserted into the sheath. Aided by X-ray images on a monitor, your doctor threads the guide catheter through that artery until it reaches your heart. The pressures in your heart chambers can be measured, and dye can be injected. The dye can be seen on an X-ray, which helps your doctor see the blood flow through your heart, blood vessels and valves to check for problems.

Cardiac computerized tomography (CT) or magnetic resonance imaging (MRI). These tests can help diagnose heart problems and detect heart murmurs. In a cardiac CT scan, you lie on a table inside a doughnut-shaped machine. An X-ray tube inside the machine rotates around your body and collects images of your heart and chest.

In a cardiac MRI, you lie on a table inside a long tube-like machine that produces a magnetic field. The magnetic field aligns atomic particles in some of your cells. When radio waves are broadcast toward these aligned particles, they produce signals that vary according to the type of tissue they are. Images of your heart are created from these signals, which your doctor will look at to determine the cause of your heart murmur.

If your doctor suspects you or your child has an abnormal heart murmur, he or she may order one or more of the following tests.A chest x ray is a painless test that creates pictures of the structures inside your chest, such as your heart and lungs. This test is done to find the cause of symptoms, such as shortness of breath and chest pain.

An EKG (electrocardiogram) is a simple test that detects and records the electrical activity of the heart. An EKG shows how fast the heart is beating, the heart’s rhythm (steady or irregular), and where in the body the heartbeat is being recorded.An EKG also records the strength and timing of electrical signals as they pass through each part of the heart.This test is used to detect and locate the source of heart problems. The results from an EKG also may be used to rule out certain heart problems.