Common Questions and Answers
Our pediatrician heard a murmur in our child and has recommended that we see a pediatric cardiologist. What happens next?
The doctor will ask questions about your child's growth, development, activity, and family history of heart disease.
The doctor will do a thorough examination of your child, including careful listening to the heart with a stethoscope. Usually, the pediatric cardiologist will order an electrocardiogram (EKG or ECG), or a test that records the heart's electrical activity.
There are many sounds the heart can make that will help classify if a murmur is "innocent" or not. Sometimes, it can be hard to characterize a heart murmur based on a physical examination and electrocardiogram. In these cases, an ultrasound of the heart, called an echocardiogram, may be done to look at the structure of the heart in detail.
We have been told that our child has an innocent murmur. Could this become a problem as they grow up?
Innocent heart murmurs do not make your child more likely to have heart attacks or high blood pressure later in life. Your child's physical activities should not be restricted because of the heart murmur. The best way to ensure a healthy heart in the adult years is to develop good exercise and eating habits as a child. Generally, a child with an innocent heart murmur will not need further cardiology follow-up.
How common are innocent murmurs?
Innocent murmurs are very common! Some pediatric cardiologists estimate a heart murmur can be heard in 90% of children with anatomically normal hearts between the ages of 4-7 years.
What if my child has a murmur that is not innocent?
Even if your child has been diagnosed with a heart murmur that is due to a structural problem of the heart, this does not mean that your child will need heart surgery. Some murmurs are due to small holes between the two lower chambers of the heart. These holes do not get bigger and often close by themselves.
Other murmurs are due to narrowing or leaking of one of the valves of the heart; however, this may be mild. Many children with structural heart disease lead normal, active lives through adulthood.
Our dentist asked if our child has a heart murmur. What does that mean?
If your child has been diagnosed with an innocent murmur, no special precautions are needed for dental procedures or other invasive medical procedures since your child has a structurally normal heart.
However, people who have certain structural heart problems (unrepaired complex congenital heart defects [CHD] that cause cyanosis, or repaired CHD within the first 6 months of the operation) are at higher risk for developing an infection of the heart (endocarditis) after routine teeth cleaning or other invasive medical procedures (for example, procedures that use a lighted scope to examine the stomach, colon or bladder).
Taking appropriate antibiotics as directed by your doctor or dentist at the time of these procedures can prevent endocarditis. It is important to maintain good oral hygiene through regular dental cleanings.
If your child needs antibiotics for these procedures because of a heart condition, your pediatric cardiologist will make note of that in the consultation letter that is sent to your primary care doctor. Most primary care doctors are comfortable prescribing the needed antibiotics before dental procedures.
It is very important that these recommendations be followed, as endocarditis is a serious infection that can be fatal.
