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Date issued:  June 2020

For review: June 2022

Ref: A-316/UJ/Neonatology/Heart Murmurs v2

PDF: Heart Murmurs [pdf] 690KB

Congratulations:

You are being discharged from hospital with your baby.

Your baby has been found to have a heart murmur. Your are being discharged because the team do not feel that your baby needs to stay in hospital.

This is because…

1. Your baby has been checked and has a normal heart

or…

1. The cause of the murmur has been found, but even though there is something in the heart that is causing the noise, it is not felt to be causing a problem with the circulation

or…

1. The murmur is most likely felt to be innocent and arrangements have been made for further review to confirm this.

You will have been told which the case is.

Symptoms may develop after discharge if there is a problem with the heart and the balance of the circulation changes. For this reason it is important to be aware of the things to look out for.

Seek advice if your baby is:

• Inactive, tired and more sleepy than usual.
• Tired and disinterested in feeds.
• Feeds poorly, takes longer to feed, doesn’t complete feeds, vomits more than usual.
• Gets short of breath or sweaty when feeding.
• Is short of breath at other times, is breathing fast.
• Uses more muscles to breath with ribs sucking in or a lot of abdominal movement.
• Is pale, grey or blue in colour.
• Has pale or clammy/cool skin.

If these symptoms start to develop then it is vital you seek medical advice.

If less than 10 days old then please contact the unit, they will advise on the best course of action.

Maternity Reception:           01752 431499

Transitional Care Ward:     01752 431851

You may be asked to come up to the hospital so your baby can be checked. It is possible that they may need to stay in, so be prepared.

At other times, your family doctor may be available and able to check your baby. They can judge whether more needs to be done and how soon.

If you are worried there might be a problem, and your baby is unwell then do not delay in seeking advice, if necessary via the emergency department, or if your baby seems very unwell, using the emergency services.

Frequently Asked Questions

What is a heart murmur?

A heart murmur is an extra or unusual sound made by the heart. Just as we can hear water flowing through pipes, we can sometimes hear the blood flowing through the heart, especially when the heart is small, beating fast and the pipes are narrower.

Usually heart murmurs are innocent and do not relate to any problem with the heart. They are very common in babies and young children because their hearts are smaller.

In newly born babies the flow of blood is a little different to later in life as the circulation is adjusting from when in the womb to when outside and independent of mum. When the baby is inside the womb the lungs are not used for breathing so there are bypass channels outside (the ‘arterial duct’) and inside (the ‘foramen ovale’) the heart to redirect the blood flow. Once the baby is born and breathes, the lungs open up, the arterial duct closes and the flow of blood changes. The change in flow through the duct during this time can make more noise which is heard as a heart murmur.

Occasionally, however heart murmurs can be linked to a problem with the way that blood flows through the heart, or a structural problem with the heart. In these cases the heart murmur may be an important sign of a potential problem

Can a heart murmur make you ill?

A heart murmur is simply a noise heard when listening to the heart. It is not an illness. If the murmur is made by normal flow through the heart there is no reason for there to be any problem whatsoever. However if the murmur is being made by abnormal flow because there is something wrong with the heart, then the problem with the heart that is causing the murmur might make your baby unwell

How do you know if you have a heart murmur?

Usually you wouldn’t know unless someone has listened to your heart with a stethoscope. There are many people who have heart murmurs, but don’t know because no one has ever listened to their heart because they are healthy.

Sometimes, very rarely, the noise made by the flow is so loud that you don’t need a stethoscope. If the noise is this loud then it is very likely that there is some problem with the heart

Do heart murmurs need treatment?

Heart murmurs are noises made by the heart. Noises do not need to be treated. If the heart murmur is innocent, there is nothing wrong with the heart and nothing to treat. On the other hand, if the murmur is present because there is something wrong with the heart, then this might need further investigation. Sometimes something needs to be done because the way the heart is working is not right.

How do I know if the heart murmur is innocent or not?

Having heard the murmur the doctors and nurses will have done a full assessment looking for any sign that there is a problem. Very often a heart ultrasound will have been done to look at the heart and check the structure and function, looking carefully at the blood flows to see if there is a problem. If anything has been found then you will be told.

Sometimes you will be going home with a plan to have an ultrasound at a later date, this is because the members of the team are reassured by the checks they have done and do not feel there is anything serious but wish for a check at a later date to find out if there is something more minor.

We are going home, what symptoms should I look out for?

If you are going home it is because the team are either reassured that there is no problem, or because after the check, something has been found which explains the noise, but not serious enough to warrant urgent admission and treatment. You will have been told which of these the case is.

Sometimes symptoms develop after discharge as the circulation is still adjusting to the outside world. If there is a problem with the heart and the balance of the circulation changes in certain ways it may begin to make your baby unwell. For this reason it is important to be aware of the things to look out for.

Usually symptoms arise because the heart has to work harder. This is like having to do exercise all the time, so you get tired. Babies & children will get tired, they may have less energy, feed less well, and over time, they may not gain weight, or even lose weight.

They may be short of breath, so are working harder, using more muscles, breathing more rapidly. Their colour may not be so good. The circulation may be poor and the skin cooler than usual. Sometimes, because of the way the blood is flowing round the system, blue blood which usually goes to the lungs may be going round the body, in which case babies may appear less pink.

If these symptoms start to develop then it is vital you seek medical advice. Usually these symptoms develop slowly and there is plenty of time to arrange a check. However very occasionally the development of these symptoms is more rapid and means that there may be a very serious problem developing and it is important to be seen soon, as treatment may be required.

What should we do if my baby develops any of these symptoms?

If these symptoms have developed then you should seek advice.

This leaflet provides contact numbers at the hospital to ring for advice if you are concerned, you may well be asked to come up to the hospital so that your baby can be checked. It is very possible that your baby may need to stay in, so be prepared.

Your family doctor may be available and able to check your baby. They can then make a judgement as to whether more needs to be done and how soon.

If you are worried that there might be a problem, and your baby is unwell then do not delay. Seek advice, if necessary via the emergency department, or if your baby seems very unwell, use the 999 emergency service.

Can murmurs disappear?

Yes. If they are not caused by something wrong with the heart and are innocent, then they may go as the heart grows and the blood flow changes. They can also go if they are caused by some of the minor things that may be wrong with the heart and which settle over time. Once these have gone, then the circulation is normal, and the murmur goes.