Heart valve disease: what a murmur really means

What it is, in plain words

The heart has four valves that open to let blood through and close to stop it coming back. A valve can become narrowed, so the heart must push harder, or leaky, so part of the blood goes backwards and the chamber enlarges. A murmur is simply the sound of turbulent flow, and not all murmurs are dangerous.

Signs to look out for

• Breathlessness on effort, then at rest
• Chest tightness and dizziness or fainting on exertion, typical of tight aortic valves
• Palpitations, often from atrial fibrillation in mitral disease
• Ankle swelling and fatigue
• Sometimes discovered as a murmur in someone with no symptoms at all

Why it happens

Causes include age-related calcification, congenital bicuspid aortic valve, rheumatic fever after untreated streptococcal throat infection, infection of the valve, and enlargement of the heart from other diseases.

How doctors confirm it

Echocardiography is the key test: it shows which valve is affected, how severe it is, and how the heart muscle is coping. Exercise testing, cardiac MRI, CT and sometimes catheterisation refine timing of surgery.

Treatments and solutions

• Watchful waiting with regular echocardiograms while the valve lesion is moderate and symptoms absent
• Medicines that treat symptoms and associated conditions, though no drug reverses a valve lesion
• Surgical valve repair, preferred for mitral leaks because it preserves your own tissue
• Surgical valve replacement with a mechanical valve, which lasts longer but needs lifelong anticoagulation, or a biological valve
• Transcatheter aortic valve implantation through the groin, now standard for many older or higher-risk patients

Living with it day to day

Look after your teeth and gums and tell any dentist or surgeon about your valve, because bacteria entering the blood can infect it. Report new symptoms early rather than waiting for the next appointment.

When to seek medical help

Seek urgent care for fainting, chest pain, sudden severe breathlessness, or fever with night sweats and a known valve problem.

This article explains general health information in simple language. It does not replace advice from your own doctor.