Heart Murmurs

A heart murmur is an unusual sound heard during a heartbeat. Our pediatric cardiologists carefully evaluate heart murmurs and help you understand whether your child’s murmur is harmless or needs further care.

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A heart murmur is a blowing, whooshing, or swishing sound heard during a heartbeat that’s caused by turbulent blood flow through the heart or nearby vessels. Heart murmurs are very common in children, and most are harmless.

Many murmurs are discovered during a routine well-child visit, sports physical, or sick appointment. While it’s natural to worry that a murmur signals a heart problem, the majority are “innocent” murmurs that do not reflect structural heart disease.

At University of Iowa Health Care Stead Family Children’s Hospital, your family has access to an entire team of pediatric cardiologists, nurses, and advanced providers who specialize in evaluating heart murmurs in children. We combine advanced diagnostic tools with compassionate, family-centered care, so you feel heard, informed, and supported every step of the way.

Heart murmur causes

Most heart murmurs do not show symptoms. Instead, they are detected by a pediatrician or primary care provider during a physical exam.

Common causes of heart murmurs in children include:

Faster blood flow in healthy, active children (“innocent” murmurs)
Normal changes during growth spurts
Temporary conditions such as fever or anemia
Small structural differences in the heart, such as minor valve variations or small holes

Innocent murmurs are especially common in childhood. One common benign murmur is called a Still’s murmur, which many children outgrow.

Heart murmur symptoms

While most murmurs are harmless, you should talk with your provider if your child has symptoms such as:

Shortness of breath
Fainting
Poor growth
Chest pain with activity
Bluish discoloration of the lips or skin

These symptoms are uncommon but may signal an underlying heart condition that requires further evaluation.

How we diagnose heart murmurs

Most children are referred for murmur evaluation after a provider hears an unusual sound during an exam. During your appointment:

Our medical assistants or nurses will check your child’s height, weight, and vital signs.
A pediatric cardiologist will take a detailed history and listen carefully to your child’s heart.

Pediatric cardiologists are specially trained to distinguish innocent murmurs from those that may require further testing. Often, the diagnosis can be made through careful listening and examination alone.

If the murmur sounds different from a typical innocent murmur, we may order an:

Echocardiogram (ECHO). An ultrasound of the heart that evaluates structure and function.
Electrocardiogram (EKG). A test that checks the heart’s electrical activity.

These tests are painless and noninvasive. If imaging is performed, we review the results with you and explain what they mean before you leave.

Treatment for heart murmurs

Treatment depends entirely on the cause of the murmur.

Innocent (benign) murmurs

Most heart murmurs in children are innocent and require no medication, activity restrictions, or procedures.

If your child has an innocent murmur, we will explain why the murmur is harmless and answer your questions, so you feel confident about your child’s heart health. Often, no further follow-up with cardiology is needed.

Murmurs related to heart conditions

If testing reveals a structural or electrical heart issue, which is uncommon, we will:

Clearly explain the diagnosis
Discuss whether treatment is needed
Connect you with the appropriate pediatric cardiology subspecialist

Treatment may range from monitoring over time to medication or, in rare cases, interventional or surgical care. If follow-up is needed, we coordinate ongoing care and communication with your child’s primary provider.