Pediatrics Common Questions, Quick Answers

Heart Murmurs and Arrhythmias

Donna D'Alessandro, M.D.
Lindsay Huth, B.A.
Peer Review Status: Internally Reviewed
Creation Date: June 2002
Last Revision Date: June 2002

• How does the heart work?
• What is a heart murmur?
• What is an arrhythmia?
• What causes an arrhythmia?
• Who can get it?
• What are the signs and symptoms of an arrhythmia?
• How is it treated?
• Can it be prevented?
• When should I call the doctor?

How does the heart work?

• The heart is a muscle.
• It has four chambers and four valves. These are like 2 rooms with four doors.
• The heart pushes out oxygen rich blood. The blood travels through the body then comes back to the heart for more oxygen.
• The process starts all over again.

What is a heart murmur?

• Heart murmurs are common.
• The term heart murmur does not mean an illness or disorder.
• A murmur is the sound of blood being pumped through the heart's chambers and valves.
• A murmur is sometimes, but not always, a sign of an arrhythmia.

What is an arrhythmia?

• An arrhythmia is when the heart does not beat at a regular pace.
• The heart may beat too fast, too slow, or irregularly.
• There are different kinds of arrhythmias, depending on where they are in the heart.
• An arrhythmia is often found by noticing a heart murmur first.

What causes an arrhythmia?

• The arrhythmia may be caused by a congenital heart defect (a heart problem from birth).
• It can be caused by heart disease or high blood pressure.
• Stress, caffeine, smoking, alcohol, pregnancy, and some medications can also cause an arrhythmia.

Who can get it?

• Anyone can have a heart murmur or arrhythmia.
• Heart murmurs are usually found when a child is between 2 and 4 years old (likely because at this age, many children can sit quietly while the doctor listens to the heart).

What are the signs and symptoms of an arrhythmia?
Symptoms of an arrhythmia can be mild to severe. They may include:

• Heart murmur
• Fast heartbeat
• Slow heartbeat
• Irregular heartbeat
• Difficulty feeding
• Difficulty breathing
• Difficulty exercising
• Feeling tired
• Chest pain
• Blue color to the lips
• Failure to thrive
• Dizziness, feeling lightheaded
• Fainting
• Sweating

How is it treated?

• The doctor will listen to the heart to check for murmurs.
• If there is a murmur, the doctor will determine where the murmur is, what type of noise it makes, when it happens, and if it changes.
• The most common type of murmur is a functional or innocent murmur.
• An innocent murmur is not harmful to a child's health. It usually goes away on its own without treatment.
• Other murmurs may be a sign that there is a problem. In this case, the doctor will likely send you to a pediatric cardiologist (a doctor who specializes in treating children's heart conditions.)
• If an arrhythmia is suspected, the doctor will find out what kind it is (where it is in the heart).
• Treatment will depend on what kind of arrhythmia it is and how severe it is.
• Avoiding caffeine may help stop mild arrhythmias.
• Medicines help many arrhythmias.
• Special devices can sometimes be put in the body to correct the arrhythmia.
• Pacemakers are sometimes used to speed up hearts that are beating too slow.
• If these treatments do not work, the doctor may recommend surgery.

Can it be prevented?

• A woman can take steps to improve her baby's chances of being born without a heart defect.
• Before pregnancy, a woman should be tested for rubella and vaccinated if needed.
• Pregnant women should avoid drugs and alcohol.
• Women with chronic health conditions should talk to their doctors before getting pregnant. Medication and diet may need to be changed.
• Genetic counselors can sometimes tell parents what their chances are of having a baby with a heart defect.

When should I call the doctor?

• Call the doctor if your child has symptoms of an arrhythmia.
• Call the doctor if you have questions or concerns about your child's treatment or condition.

Quick Answers

• The heart pumps blood through its chambers and valves then pushes oxygen rich blood out to the rest of the body.
• A heart murmur is the sound of blood being pumped through the heart's chambers and valves.
• An arrhythmia is when the heart does not beat at a regular pace.
• Arrhythmias can be caused by birth defects, heart disease, high blood pressure, and various factors during pregnancy.
• Anyone can have a heart murmur or arrhythmia.
• Arrhythmias are often discovered after the doctor notices a heart murmur.
• Treatment will depend on what kind of arrhythmia it is and how severe it is. The doctor will probably recommend seeing a special heart doctor, called a cardiologist.
• Pregnant women should talk to their doctors about taking steps to prevent heart defects in their babies.
• Call the doctor if your child has symptoms of an arrhythmia.

References

• American Heart Association. What are Arrhythmias? 2002 (cited 2002 April 8). URL: http://216.185.112.5/presenter.jhtml?identifier=560
• Rutherford, K. Heart Murmurs and Your Child. KidsHealth. 2001 June (cited 2002 April 8). URL: http://kidshealth.org/parent/medical/heart/murmurs.html
• Texas Heart Institute. 2001 May (cited 2002 April 8). URL: http://www.tmc.edu/thi/arrhythm.html