10 minute read
Medically reviewed by Dr Ravi Assomull, Consultant Cardiologist – 14 October 2026
Introduction
Being told by a doctor that they have detected a heart murmur can be an unsettling experience. For many adults, the phrase conjures immediate concern — but the reality is often far less alarming than the name suggests. A heart murmur is simply an extra or unusual sound heard through a stethoscope during a heartbeat, and in many cases, it is entirely harmless.
That said, understanding what a heart murmur is, why it occurs, and when it may warrant further investigation is important for anyone who has received this finding — or who suspects they may have one. People across the UK frequently search online for clear, trustworthy information on this topic, often following a routine GP appointment or health check.
This article explains what a heart murmur is, explores the possible causes in adults, outlines the tests that may be recommended, and helps you understand when professional cardiology assessment could be appropriate.
What Is a Heart Murmur?
What is a heart murmur and is it dangerous in adults?
A heart murmur is an extra or unusual sound heard between heartbeats when a doctor listens with a stethoscope. In adults, murmurs are often harmless (known as innocent murmurs), but some can indicate an underlying heart valve problem or other cardiovascular condition that warrants further investigation.
A normal heartbeat produces two distinct sounds — often described as "lub-dub" — caused by the closing of heart valves. A heart murmur is an additional whooshing, swishing, or rasping sound that occurs within this cycle. It is detected by a clinician during physical examination and is not something a person can hear or feel themselves.
It is important to understand that a murmur is not itself a diagnosis — it is a clinical finding. Many heart murmurs are described as innocent or functional, meaning they occur in an otherwise healthy heart and require no treatment. Others may be pathological, meaning they are caused by an underlying structural issue, most commonly a problem with one of the heart's four valves.
How the Heart Works: Understanding Blood Flow and Heart Valves
To understand why heart murmurs occur, it helps to appreciate how the heart normally functions.
The heart is a muscular pump divided into four chambers: the right atrium, right ventricle, left atrium, and left ventricle. Blood flows through these chambers in a carefully controlled sequence, directed by four valves — the mitral, tricuspid, aortic, and pulmonary valves — that open and close with each heartbeat to keep blood moving in one direction.
When these valves work normally, blood flows smoothly and quietly. If a valve becomes narrowed (a condition called stenosis) or fails to close properly (known as regurgitation or a "leaky valve"), blood may flow turbulently or in the wrong direction. This turbulent blood flow creates the sounds we associate with a pathological heart murmur.
Understanding this mechanism helps explain why a specialist will want to identify not just that a murmur is present, but also which valve is involved, how significant the turbulence is, and whether it is affecting how well the heart is pumping.
Common Causes of Heart Murmurs in Adults
There are a number of reasons why a heart murmur may be detected in an adult:
Innocent or functional murmurs may occur due to:
- Increased blood flow through the heart (for example, during pregnancy, fever, or anaemia)
- Vigorous physical fitness in athletes
- Anxiety or an elevated heart rate
Pathological murmurs may be related to:
- Aortic stenosis — narrowing of the aortic valve, more common in older adults
- Mitral regurgitation — a leaking mitral valve
- Aortic regurgitation — blood flowing back through the aortic valve
- Mitral valve prolapse — a common, usually mild, condition where the mitral valve does not close perfectly
- Congenital heart defects — structural heart abnormalities present from birth that may go undetected until adulthood
- Infective endocarditis — infection of the heart valves
- Rheumatic heart disease — a late complication of untreated streptococcal infection
A clinician will consider a person's full clinical history, symptoms, age, and risk factors when assessing the likely significance of a murmur.
Symptoms That May Accompany a Heart Murmur
Many adults with innocent heart murmurs experience no symptoms whatsoever, and the murmur is discovered only incidentally during a routine check-up.
When a murmur is related to an underlying heart valve condition, some people may notice symptoms such as:
- Shortness of breath, particularly on exertion
- Fatigue or reduced exercise tolerance
- Heart palpitations or an irregular heartbeat
- Chest discomfort or tightness
- Light-headedness or dizziness
- Ankle swelling
Important: These symptoms can have many possible causes and are not exclusively associated with heart murmurs or valve disease. They should never be used to self-diagnose. If you are experiencing persistent or unexplained symptoms of this nature, appropriate medical assessment is advisable.
If you experience severe chest pain, sudden severe shortness of breath, fainting, or symptoms that may suggest a medical emergency, seek urgent medical attention immediately — do not wait for a routine cardiology appointment.
How Is a Heart Murmur Investigated?
If a heart murmur is detected, a clinician will determine whether further investigation is appropriate based on individual clinical circumstances. Not every murmur requires further testing, but where there is any uncertainty or concern, investigations may be recommended.
Echocardiogram
The most important investigation for assessing a heart murmur is an echocardiogram. This is an ultrasound scan of the heart that provides detailed images of the heart's structure, chambers, and valves in real time. It can show:
- Whether a valve is narrowed or leaking
- How well the heart is pumping (ejection fraction)
- The size and function of the heart chambers
- Whether there are any structural abnormalities
An echocardiogram is non-invasive and is generally well tolerated by most patients. No special preparation is usually required, and most scans take around 30 to 45 minutes. It is a well-established and commonly used investigation for assessing heart murmurs.
ECG (Electrocardiogram)
An ECG may be performed alongside an echocardiogram. It records the electrical activity of the heart and can identify rhythm abnormalities, signs of heart strain, or changes in heart electrical conduction that may be relevant in the context of a valve problem.
Additional Tests
Depending on clinical findings, a cardiologist may also recommend:
- Chest X-ray — to assess heart size and lung fields
- Blood tests — to check for anaemia, infection, or heart strain markers
- Exercise stress testing — to assess how the heart responds to physical exertion, which can be particularly useful in patients whose symptoms occur mainly on exercise
- Cardiac MRI — in certain complex cases, to provide more detailed structural information
When to See a Cardiologist About a Heart Murmur
You may wish to consider a private cardiology consultation in the following circumstances:
- A GP or other clinician has detected a heart murmur and recommended specialist review
- You have been told you have a heart murmur but have not had it formally assessed
- You have a known murmur and are experiencing new or worsening symptoms
- You have a family history of heart valve disease or congenital heart conditions
- You would like a specialist opinion or reassurance following a previous finding
A cardiologist can assess your murmur in full clinical context, arrange appropriate investigations, and explain clearly what the findings mean for your individual health.
Supporting Your Heart Health
Whether or not a heart murmur requires treatment, supporting overall cardiovascular health is always beneficial. The following general measures are supported by evidence:
- Eating a balanced, heart-healthy diet rich in vegetables, fruit, whole grains, and lean protein
- Taking regular physical activity appropriate to your individual health status
- Not smoking — smoking significantly increases cardiovascular risk
- Keeping blood pressure within a healthy range through lifestyle measures and, where needed, medical management
- Maintaining a healthy weight
- Limiting alcohol intake
- Managing stress and getting adequate sleep
It is important to note that cardiovascular risk varies considerably between individuals depending on age, family history, existing health conditions, and lifestyle. Lifestyle changes are not a guarantee against heart disease, but they can meaningfully support long-term heart health.
Key Points to Remember
- A heart murmur is an extra sound heard through a stethoscope — it is a clinical finding, not a diagnosis in itself
- Many heart murmurs in adults are innocent and do not indicate any serious underlying problem
- Some murmurs are related to heart valve conditions that may benefit from monitoring or treatment
- An echocardiogram is the principal investigation used to assess a heart murmur
- Symptoms such as breathlessness, palpitations, or chest discomfort alongside a murmur should be assessed by a clinician
- Urgent symptoms — including severe chest pain or sudden fainting — require immediate medical attention
- Appropriate assessment depends on individual clinical circumstances; not every murmur requires the same level of investigation
Frequently Asked Questions
Can you feel a heart murmur yourself?
No. A heart murmur is a sound — not a sensation. It cannot be felt by the person who has it and is only detectable by a clinician using a stethoscope. Most people are completely unaware they have a heart murmur until it is picked up during a routine medical examination. If you are experiencing symptoms such as palpitations or breathlessness, these may be related to a number of different causes and should be assessed by a clinician rather than attributed solely to a murmur.
Do heart murmurs go away on their own?
Innocent heart murmurs — those caused by increased blood flow rather than a structural problem — can resolve once the underlying cause is addressed. For example, a murmur that appears during pregnancy typically disappears after delivery. Murmurs related to structural valve problems do not resolve on their own, though some remain stable for many years. A cardiologist can advise on monitoring and management based on individual findings.
Is a heart murmur the same as a heart condition?
Not necessarily. A heart murmur is a physical finding — a sound — that may or may not be associated with an underlying heart condition. Many people with a heart murmur have a structurally normal heart and no cardiovascular disease. Others may have a murmur caused by a valve abnormality that requires monitoring or, in some cases, treatment. Proper investigation is the only way to distinguish between the two.
Can adults develop a heart murmur later in life?
Yes. While some murmurs originate from congenital abnormalities present from birth, others develop during adulthood. Age-related valve changes — particularly aortic valve calcification and stenosis — are increasingly common as people get older. Certain infections, inflammatory conditions, and changes in blood flow can also lead to murmurs developing in adult life. Regular health checks can help detect such changes early.
How is a heart murmur graded?
Clinicians grade heart murmurs on a scale from Grade 1 (very faint, heard only in ideal conditions) to Grade 6 (very loud, audible even without a stethoscope pressed against the chest). The grade gives some indication of how pronounced the sound is, but does not necessarily reflect the severity of any underlying condition. A Grade 2 murmur may be associated with significant valve disease in some individuals, while a louder murmur may be innocent in others. Clinical context and echocardiographic assessment are far more informative than grade alone.
Is it safe to exercise if I have a heart murmur?
For most people with innocent heart murmurs, exercise is entirely safe and should be encouraged as part of a healthy lifestyle. If a murmur is related to a valve condition, the appropriate level of physical activity will depend on the type and severity of the problem. A cardiologist can advise on exercise suitability based on your individual clinical findings. You should not make significant changes to your exercise habits based on a murmur finding alone without seeking appropriate medical advice.
Conclusion
A heart murmur is a relatively common clinical finding in adults and, in many cases, is entirely harmless. However, it is a finding that deserves appropriate attention — particularly if it has not previously been investigated, if it is associated with symptoms, or if a clinician has recommended further assessment.
The key step for anyone concerned about a heart murmur is proper clinical evaluation, which typically centres on an echocardiogram to assess the heart's structure and valve function. From there, a cardiologist can provide clear, individualised guidance on whether further monitoring, lifestyle support, or treatment is appropriate.
Cardiovascular symptoms, test results, and treatment options should always be assessed individually based on a person's clinical history, symptoms, and appropriate medical examination.
If you have any concerns about a heart murmur or other aspects of your heart health, do not hesitate to seek advice from a qualified healthcare professional. And if you ever experience severe or sudden symptoms that may suggest a cardiac emergency, seek urgent medical attention without delay.
Disclaimer: This article is intended for general educational purposes only and does not constitute personalised medical advice, diagnosis, or treatment. Cardiovascular symptoms and conditions can vary between individuals. If you have concerns about your heart health or symptoms, seek appropriate advice from a qualified healthcare professional. If you experience symptoms that may indicate a medical emergency, seek urgent medical attention.
Next Review Due: 14 October 2027
