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The heart is one of the main organs of the human body, which acts as a pump in charge of sending blood to the rest of the organs and systems that make it up.

During this process, called the cardiac cycle, a sequence of electrical, mechanical, sound and pressure events occurs, related to the passage of blood flow through the cardiac chambers, whose mission is to maintain hemodynamic stability and supply blood to the Body.

We know these sound events as heart beat, which represent the natural noises resulting from the opening and closing of the different valves present in the heart and which some authors describe as a constant Lub-Dup / Lub-Dup, which we can hear easily during auscultation with a stethoscope.

These two consecutive sounds represent the closing of the valves of the heart. The first Lub - Dup then corresponds to the closure of the mitral and tricuspid, or of the valves that separate the atria from the ventricles, while the second Lub - Dup is the sound produced by the valves of the Aorta and the pulmonary arteries when closing.

What are heart murmurs

When there is an anatomical alteration, in which the natural structure or physiological alterations are modified, where the normal functioning of this organ is affected, heart murmurs will originate, also known as heart murmurs, these murmurs are unusual sounds, which, as its name indicates, are characterized by being similar to a whistle or whistle. They are the result of the turbulent passage of blood through the altered heart structure.

Although these are not always pathological, in some cases, heart murmurs are innocent, in this way, the American Cardiology Association describes harmless or physiological murmurs, which are due to an increase in blood flow speed or to the change in the diameter of the cardiac structures through which the blood flows. These murmurs will be considered physiological as long as there are no symptoms of heart disease or clinical signs of heart failure.

Causes of heart murmurs

As we mentioned before, there are two types of heart murmurs or heart murmurs, these can be physiological or pathological, that is, they can be harmless or harmful.

1. Functional heart murmurs

Due to accelerated blood flow to the heart, some of the causes of faster-than-normal flow to the organ can be:

• Physical activity or exercise.
• Anemia (decrease in red blood cells responsible for transporting oxygen to organs and body systems)
• Hyperthyroidism (Increased levels of thyroid hormone in the body)
• Phases of accelerated growth, such as adolescence

As we can see, none of the aforementioned causes directly or structurally alters the cardiovascular system.

1. Pathological heart murmurs

• Functional or structural alterations of the heart valves may be present from birth or develop over the years. In some cases, these abnormalities do not allow blood to flow correctly through the valves (as in mitral valve stenosis) or do not allow proper closure of the valves, causing regurgitation of blood (as in insufficiency mitral or tricuspid).
• Interatrial or interventricular communication, are holes located in the walls that separate the atria or ventricles from each other, causing a continuous blood flow between both cavities, this communication is not normal and depending on the size and specific location, we can determine the level severity of it.
• Endocarditis, infection of the inner membrane and valves of the heart due to the spread of microorganisms from other parts of the body, such as the mouth, venipuncture sites, etc. In general, infective endocarditis occurs in people with previous alterations in some of the cardiac structures.
• Rheumatic Fever, is a systemic inflammatory disease which originates from a bacterial pharyngeal infection, which causes joint, skin, subcutaneous cellular tissue and heart alterations.

Signs and symptoms

If the murmur is innocent, benign or physiological, there will be no other signs or symptoms in addition to the hissing or hissing sound during cardiac auscultation, on the other hand, if this murmur is pathological, the patient will present a set of manifestations that will help the doctor to reach the correct diagnosis and that indicate that we are certainly in the presence of a cardiac alteration, among the main findings we have:

• Peripheral cyanosis or bluish discoloration of the lips and fingertips.
• Edema or increase in volume, which occurs mainly in the lower limbs.
• Dyspnoea or shortness of breath, shortness of breath, or difficulty breathing, especially when lying down, accompanied by a persistent cough.
• Engorgement or enlargement of the neck veins.
• Chest pain
• Dizziness
• Fainting or loss of consciousness.

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