Why does noise occur?
Normally, blood flows through the chambers of the heart in an even flow and only two sounds are heard - the closing of the valves. The noise appears when the flow becomes a vortex. This occurs when the valve narrows, when blood breaks through a narrow opening, when the valves are not completely closed with the reverse flow of blood, when there is a hole between the chambers, and also when the speed of blood flow is increased without any defects. The latter option is called a functional, or innocent, murmur: the heart is healthy, and the sound is caused by the characteristics of the blood flow at a particular moment.
- Valve narrowing - stenosis
- Incomplete closure of the valves - insufficiency
- The hole between the chambers of the heart
- Accelerated blood flow without defect
- Changes in valve structure with age
When the noise is harmless
Functional noise in adults is most often soft, short, heard in a certain position and disappears after the cause is eliminated. It is caused by anemia, in which the blood becomes less viscous and flows faster, fever, increased thyroid function, pregnancy with an increased volume of circulating blood, physical stress and dehydration. In such cases, echocardiography shows normal valves and chambers of the heart, no cardiac treatment is required, and attention is directed to eliminating the cause of the accelerated blood flow.
- Anemia
- High temperature
- Increased thyroid function
- Pregnancy
- Dehydration
- Intense physical activity
When noise indicates illness
Rough, prolonged noises, as well as any diastolic noise, that is, sound in the relaxation phase of the heart, are alarming. Their cause is most often acquired valve defects: narrowing of the aortic valve in the elderly due to calcium deposits, damage to the mitral valve after rheumatic fever, prolapse with backflow of blood. Less common are congenital septal defects, first identified in adulthood, as well as infectious inflammation of the inner lining of the heart, in which the murmur appears against a background of prolonged fever.
- Aortic stenosis, often with calcification in the elderly
- Mitral regurgitation and mitral valve prolapse
- Consequences of rheumatic fever
- Congenital septal defects
- Infective endocarditis
- Aortic expansion
What examinations are needed
They begin by examining and listening to the heart in different positions, measuring pressure in both arms, assessing pulse and edema. An ECG is required, which shows overload of the heart and rhythm disturbances. The key test is echocardiography: it allows you to see the valves, measure the flow rate, determine the degree of stenosis or backflow and the size of the chambers. Additionally, a general blood test is taken to rule out anemia and TSH. If there are complaints of interruptions, daily ECG monitoring is prescribed, and if endocarditis is suspected, blood cultures are prescribed.
- Examination and auscultation by a cardiologist
- ECG
- Echocardiography - main study
- General blood test
- TSH
- Daily ECG monitoring during interruptions
- Blood culture for suspected endocarditis
What to do next
If echocardiography does not reveal changes, and the cause of accelerated blood flow is eliminated, heart treatment is not necessary; observation and control of the underlying condition is sufficient. If a defect is detected, the tactics depend on the degree: mild changes require regular repetition of echocardiography, moderate changes require blood pressure monitoring, treatment of concomitant diseases and limitation of heavy exercise on the recommendation of a doctor. In cases of severe stenosis or insufficiency, surgery or endovascular intervention is discussed. It is important for people with defects to carefully treat their teeth and not cause infections.
- Observation and control echocardiography according to the doctor’s schedule
- Elimination of anemia, fever, thyroid disorders
- Blood pressure control
- Limiting exercise only on the advice of a doctor
- Sanitation of the oral cavity and treatment of foci of infection
- Surgical treatment for severe defects
