Clear, prompt assessment of a heart murmur found on examination, with straightforward advice on what it means and whether further tests are needed.
A heart murmur is an extra sound heard between or alongside the normal heartbeats, usually picked up during a routine examination by a GP, at a medical, or in pregnancy.
Many murmurs are harmless flow murmurs. Others reflect a valve that is narrowed or leaking, or a structural heart condition that needs proper characterisation. The murmur itself is not a diagnosis. The assessment is about deciding what it represents and whether echocardiography or follow-up is needed.
Most murmurs are picked up incidentally in someone who feels entirely well and can be assessed on a routine private basis. That is not the case if a murmur is found alongside chest pain, blackouts, severe breathlessness, blue lips, or signs of acute heart failure.
If you are acutely unwell, seek emergency care first. Private assessment is suitable for stable patients who need a clear explanation and a sensible investigation plan.
These are common, especially in children, younger adults, pregnancy, fever, anaemia or thyroid overactivity. The murmur reflects normal blood moving quickly through a structurally normal heart.
A murmur can also come from a valve that has become narrowed or does not close fully, or from another structural heart problem. The murmur itself does not reliably tell you severity; that usually needs imaging.
Dr Cassar takes a focused history, including when the murmur was first heard, any symptoms of breathlessness, chest discomfort, palpitations or reduced exercise tolerance, and relevant background such as pregnancy, anaemia or previous heart disease.
Examination helps characterise the murmur and look for associated signs. A resting ECG may be performed. If the murmur is new in adulthood, unclear, or potentially structural, an echocardiogram is usually the key test.
The key test for a murmur, showing valve structure, how well valves open and close, and heart chamber size and function.
A resting tracing to look for rhythm abnormalities, chamber strain or other clues that support the clinical picture.
Useful when anaemia or an overactive thyroid is a plausible explanation for a flow murmur.
Considered in specific cases where symptoms with exertion need clarifying alongside a murmur.
Not necessarily. Many murmurs are innocent flow murmurs in a structurally normal heart. Others reflect a valve or structural problem that needs characterising.
An innocent flow murmur can become louder or quieter depending on circulation, for example during fever, exercise or pregnancy. A structural valve murmur is usually more consistent, though examination findings can vary.
No. Loudness gives clues but does not reliably predict severity. A quiet murmur can occasionally reflect significant valve disease, while a loud one can be innocent.
Not always. An echocardiogram is arranged when the clinical picture is unclear, new in adulthood, or suggests a structural valve issue.
Yes. Anaemia, fever, pregnancy and an overactive thyroid can increase blood flow enough to produce a flow murmur. The assessment considers these reversible contributors.
Private appointments are usually available within days. If there are acute symptoms such as blackout, chest pain or severe breathlessness, emergency care is more appropriate.
If a heart murmur has been picked up and you would like it properly assessed, a consultation can clarify whether it is likely to be innocent or needs imaging. Appointments are available in Basingstoke and Winchester.
