Your heart is a noisy muscle. Just put your ear to a friend's chest and listen. That lub-dub sound is the four heart valves opening and closing. With a stethoscope, a skilled practitioner hears these valve sounds even clearer and sometimes detects a heart murmur, which is a sound typically caused by a faulty valve.
Getting to Know Your Valves
Your heart is an incredibly durable little pump. Averaging between 40 and 100 beats per minute (depending on your age and athleticism), it circulates all your blood -- about six quarts -- every minute. But what parts of the heart is all that blood moving through?
It's important to understand the heart's structure. The muscle houses two upper chambers (the atria) and two lower chambers (the ventricles). A little flap of tissue seals each chamber, and the heart's contractions flip these valves open and closed. The "lub" sound comes from the valves closing at the top of the heart, while the "dub" emanates from the bottom ones.
The atria valves include the tricuspid and mitral, and the ventricle valves are the pulmonary and aortic. These valves may have a number of issues, but heart murmurs usually revolve around a specific valve and a particular problem.
Heart Murmur Types
A heart murmur is not a condition on its own, but it does potentially indicate something else going on in the heart. For example, many healthy children grow out of "innocent" heart murmurs that don't indicate any heart disease. An abnormal murmur, however, originates among people born with congenital heart defects affecting one or more valves.
Acquired valve diseases, which are caused by aging, infections, and other diseases, occur later in life and are a far more common source of abnormal heart murmurs. In adults, these diseases primarily affect the aortic or mitral valves. There are three common valve problems, and some people may have more than one:
- If a valve does not close completely, a backflow of blood may occur in the chamber. This process, called regurgitation, prevents blood from circulating through the heart properly.
- Stenosis damages valves, causing limited blood flow.
- With atresia, a newborn's valve (most often the pulmonary valve)provides little to no opening.
Detecting a Heart Murmur
When a health care provider puts a stethoscope to your chest, one of the things he listens for is a heart murmur. The timing, volume, and location of the noise determine the possible cause. If your doctor suspects an abnormal murmur, then he may refer you to a cardiologist for further evaluation. Depending on your history, you may undergo diagnostic tests such as a chest X-ray, an electrocardiogram (ECG or EKG), or an echocardiography (echo).
Living With a Heart Murmur
In most cases, heart murmurs are harmless and only require monitoring, allowing you to go about your normal lifestyle, but sometimes a valve disease or other heart condition may have a greater effect. Your cardiologist may only recommend lifestyle changes, such as improving your diet, getting more exercise, or quitting smoking, but he may also prescribe medications to treat the symptoms or condition. People with more severe issues may need surgery to repair or even replace any dysfunctional heart valves.
While there is no cure for valve disease, medication and proper lifestyle changes go a long way toward limiting its effect on day-to-day life. On the other hand, heart failure is more likely to follow untreated valve disease because the heart has to work harder to compensate for a dysfunctional valve. In the worst-case scenario, blood clotting, which is sometimes caused by unchecked valve diseases, can lead to cardiac arrest or a stroke.
You may be unaware of any valve problem, but certain symptoms offer clues. Some of the most common include:
- Feeling lightheaded or dizzy.
- Swelling in the abdomen or ankles and feet.
- Shortness of breath.
- Skipping or rapid heartbeat.
- Chest pain.
When you consider the millions of times those little flaps open and close, the durability of the heart's four valves is quite impressive. The key to taking care of them is prevention. You can do much of this simply by living a healthy lifestyle and scheduling routine checkups with your health care provider.