Heart failure and a heart murmur: what to know

A murmur is a finding heard through a stethoscope, while heart failure describes symptoms and signs caused by the heart not pumping or relaxing effectively enough. A valve problem can contribute to heart failure, but many people with a murmur do not have heart failure. Heart failure may present with breathlessness, fatigue, cough, swollen ankles or reduced activity tolerance. Palpitations can suggest a rhythm issue such as atrial fibrillation and should be described separately to the clinician.

If a murmur has been newly heard, arrange the recommended medical review even if you feel well. Tell the clinician about breathlessness, fainting, chest discomfort, reduced exercise ability, palpitations and any family history of heart disease. Assessment may include blood pressure measurement, an electrocardiogram and an echocardiogram, which uses sound waves to examine valves and heart function. Take previous reports and your medicine list to the appointment.

Seek emergency help for chest pressure, severe breathlessness, fainting, sudden confusion, blue lips or a fast heartbeat with collapse or marked weakness. Get prompt advice if breathlessness is worsening, swelling develops quickly, or you cannot do usual activities. Urgency is determined by symptoms and change over time, not by the sound of a murmur alone.

Ask where the murmur is heard, whether it suggests a valve problem, and whether an echocardiogram is needed. Clarify which symptoms should prompt urgent contact, whether activity needs changing, and when the result should be reviewed. If a heart condition is found, ask how medicines and a chronic disease review fit into follow-up.