Heart Murmur and Exercise

What is a Heart Murmur?

Simply put, a heart murmur is a sound not normally heard when listening to the valves of the heart. Normally we hear the valves closing as blood moves through the heart something like “lub-DUB” with each heart beat.

The ‘murmur’ is an extra sound sometimes like a swishing noise which can be hardly heard or very loud.

Most times if diagnosed as a child, this sound can be harmless (also called innocent). An innocent murmur is not caused by heart problems and can be commonly found in children at some point. So if diagnosed as a child it could be most likely normal. There are no necessary exercise restrictions in ‘innocent’ murmurs.

Other names for these innocent heart murmurs include: benign, flow, functional, mammary souffle (during pregnancy), normal, physiological, Still’s murmurs or venous hums.

If as a child you were diagnosed with an ‘abnormal’ heart murmur it is most likely caused by congenital heart defects (i.e. problems with the heart structure present at birth). Please refer to the exercise section below under ‘abnormal heart murmur’.

ADULTS diagnosed with Heart Murmurs

During pregnancy: your body makes extra blood and can cause a heart murmur which is no longer present after birth. Therefore most heart murmurs found during pregnancy are simply a physiological response and innocent.

Other causes mostly in adults can be classified as ‘abnormal’ or pathologic heart murmurs. This is most often caused by developing heart valve disease (usually caused by another condition such as infections, diseases or simply aging).

A heart murmur in itself is NOT a disease. Therefore, with an ‘abnormal’ murmur we can look for the underlying cause. These underlying causes may require medical intervention such as medication. The treatments will depend on the type and severity of the underlying heart problem causing the abnormal murmur.

EXERCISE with Heart Murmur

Firstly you must determine the classification of your heart murmur and ALWAYS consult your physician BEFORE engaging in new or unusual physical activity. Having said that, here is my view based on my understanding of the condition as an Exercise Physiologist:

Innocent heart murmur: (where there is no treatment involved i.e. you are not on medication related to the heart or murmur) does not require you to limit your physical activity or do anything special.

Abnormal heart murmur: after consulting your personal physician and following his/her advice, you may engage in moderate physical activity and check for any signs or symptoms that may suggest a problem

Remember, people who have innocent (harmless) heart murmurs don’t have any signs or symptoms other than the murmur itself. This is because innocent heart murmurs aren’t caused by heart problems.

People who have abnormal heart murmurs may have signs or symptoms of the heart problems causing the murmurs. These signs and symptoms may include:

  • Shortness of breath, which may occur only with physical exertion
  • Excessive sweating with minimal or no exertion
  • Chest pain
  • Dizziness or fainting
  • A bluish colour on the skin, especially on the fingertips and lips
  • Chronic cough
  • Swelling or sudden weight gain
  • Enlarged neck veins

Signs and symptoms depend on the problem causing the heart murmur and its severity. IF YOU EXPERIENCE ANY OF THESE SYMPTOMS EITHER DURING OR AFTER ENGAGING IN PHYSICAL ACTIVITY you should consult your physician as soon as possible to check if the heart murmur is causing your sign or symptoms to occur.

 

REFERENCE: For further information about Heart Murmurs and Heart Defects,  check out the National Heart, Lung and Blood Institute:

https://www.nhlbi.nih.gov/health/health-topics/topics/heartmurmur/links.html