If you’ve ever found yourself sitting in a cardiology exam room, listening to the familiar whoosh-tap-thump of a stethoscope pressed to your chest, you might have heard your doctor pause, lean in a little closer, and note a “murmur.” For many people, a heart murmur sounds scary—like a warning sign that something’s wrong with their heart. As someone who’s worked in the heart health supply industry for over a decade, I’ve seen firsthand how confusion around murmur diagnosis can lead to unnecessary stress, or even missed answers when a murmur is more than just a harmless quirk. Today, I want to break down exactly how a heart murmur is diagnosed, demystify the process, and explain why accurate, timely testing matters—not just for patients, but for the teams that develop and deliver heart care tools like the ones my company provides. Heart
First, let’s get clear on what a heart murmur actually is. It’s not a disease, exactly—it’s an extra sound your heart makes when blood doesn’t flow through your heart valves or chambers smoothly. Normal heartbeats are “lub-dub,” the sound of your valves closing as blood is pushed out of your heart. A murmur is an extra whooshing or swishing between those two sounds, and it can happen in people of all ages, from newborns to retirees. Some murmurs are innocent (called “functional murmurs”)—they come from things like pregnancy, fever, or even strenuous exercise, and they don’t signal a heart problem. Others are abnormal (“pathological murmurs”), linked to issues like leaky valves, narrowed arteries, or holes in the heart. The difference between them is where diagnosis comes in.
The first step in diagnosing a murmur is the part most people know: the stethoscope exam. But it’s not just a quick listen. A cardiologist will carefully assess the murmur’s characteristics to spot clues. They’ll note when the murmur happens—during “lub” (systole, when the heart contracts) or “dub” (diastole, when it relaxes). They’ll check its pitch (high or low), its intensity (how loud it is, on a scale of 1 to 6), and where it’s heard loudest on the chest—whether it’s near the top of the heart (aortic or pulmonic valve areas) or the bottom (mitral or tricuspid). They’ll also have you move, hold your breath, or lean forward to see how the murmur changes—movement can tell them if it’s linked to blood flow through a valve or a chamber. For example, a murmur that gets louder when you stand up often points to aortic stenosis, a narrowed valve, while one that softens when you press on your belly might be related to a problem in the right side of the heart.
But here’s where things get nuanced: a stethoscope alone can’t tell the difference between an innocent and abnormal murmur. I’ve spoken with dozens of cardiologists over the years who’ve told me stories of young patients dismissed for “harmless” murmurs only to be diagnosed with a valve disorder later—because the stethoscope, while critical, has limits. That’s why the next steps in diagnosis are all about imaging and tests that give a clear, detailed look at the heart’s structure and function.
The most common follow-up test for a murmur is an echocardiogram, or “echo” for short. This is an ultrasound of the heart, and it’s the gold standard for murmur diagnosis. Using sound waves, it creates moving pictures of your heart’s chambers, valves, and blood flow. When a cardiologist orders an echo, they can see exactly why a murmur exists: is a valve leaky? Is an artery narrowed? Is there a hole between the heart’s upper chambers? The test is non-invasive, no radiation, and takes just 30 to 60 minutes. As someone who works in heart supply, I know just how vital this tool is. My company produces high-quality echo probes and portable ultrasound units that make these tests accessible, even in small clinics or rural hospitals where specialized cardiology teams might be scarce. Many of our products are designed to be lightweight and easy to use, so a nurse in a community clinic can perform an echo and get an accurate reading, cutting down on wait times for patients who might need further care.
Sometimes, though, an echo isn’t enough. If a murmur is linked to the heart’s electrical system or blood flow during activity, a cardiologist might order a stress test. This test measures how your heart works when it’s working harder, usually on a treadmill or stationary bike, while connected to an EKG (electrocardiogram). For people who can’t exercise—like older adults or those with mobility issues—a chemical stress test uses medication to make the heart work harder, mimicking the effects of exercise. During a stress test, if the murmur gets louder or the EKG shows changes, that can point to an abnormality that only shows up when the heart is under strain.
Another test that’s used for more complex murmurs is a cardiac MRI. This imaging test creates detailed, 3D pictures of the heart, showing things that an echo might miss—like damage to the heart muscle, or problems with the coronary arteries that supply blood to the heart itself. Cardiac MRIs are often used when a doctor needs a clearer view of a valve disorder, or to plan for procedures like valve replacement. For patients who have had a murmur diagnosed and need ongoing care, MRIs can track how a condition is progressing over time, making sure that treatment is adjusted as needed.
In some cases, especially when a murmur is very loud or linked to other symptoms like shortness of breath, chest pain, or fainting, a doctor might recommend a cardiac catheterization. This is a more invasive test, where a thin tube (catheter) is inserted into a blood vessel in the arm or groin, threaded up to the heart. Dye is injected through the catheter, and X-rays are taken to get clear images of the heart’s arteries and valves. This test isn’t used as a first step, but it’s critical for diagnosing severe blockages or valve problems that might require surgery. As a heart supply professional, I know that cardiac catheters are one of our core products—we work with hospitals around the world to provide sterile, precision-made catheters that make these procedures as safe as possible for patients.
It’s important to note that not all murmurs need further testing. Many innocent murmurs, especially in children and young adults, require no follow-up at all. A pediatric cardiologist might hear a murmur during a well-baby checkup, but as long as there are no other symptoms—like poor weight gain, fatigue, or shortness of breath when playing—they’ll often just monitor it over time. That’s why the diagnosis process is just as much about ruling out problems as it is about finding them. For patients, this can be a big relief: a murmur doesn’t automatically mean heart disease, and the tests are designed to separate the two.
As I’ve watched the heart health industry evolve over the years, one thing has become clear: the accuracy of murmur diagnosis depends on having the right tools, accessible to the right people. Ten years ago, many small rural clinics couldn’t afford high-quality echo machines, so patients with murmur symptoms had to travel hours to see a cardiologist. Today, thanks to innovations in portable, affordable ultrasound technology—products my company helps develop and distribute—those clinics can perform basic echo tests on-site, cutting down on wait times and making diagnosis faster. That’s not just good for patients; it’s good for the entire heart care chain, from the first exam room to the operating room when surgery is needed.
If you or a loved one has been told you have a heart murmur, don’t hesitate to talk to your doctor about the diagnosis process. Ask what kind of test might be right for you, and don’t be afraid to get a second opinion if you’re unsure. For healthcare providers out there, making sure your team has access to reliable, easy-to-use heart care tools—from stethoscopes to echo probes—can make all the difference in identifying and managing murmurs early.
When it comes to heart health, knowledge is power. A timely, accurate diagnosis of a murmur can prevent serious complications down the line, and the right tools make that possible. If you’re a healthcare professional looking to upgrade your diagnostic equipment, or a care team that needs support in improving murmur diagnosis processes, we’re here to help. Reach out to our team to explore how our heart supply solutions can support your patients and your practice.
Cushion References
- American Heart Association. (2023). Heart Murmurs in Adults. Retrieved from American Heart Association clinical resources
- National Heart, Lung, and Blood Institute. (2022). What Are Heart Murmurs? Retrieved from NHLBI patient education resources
- European Society of Cardiology. (2021). Guidelines for the Management of Heart Valve Diseases. European Heart Journal
- U.S. Preventive Services Task Force. (2020). Screening for Cardiovascular Disease in Adults. Annals of Internal Medicine
- American College of Cardiology. (2022). Echocardiography in the Evaluation of Heart Murmurs. Journal of the American College of Cardiology
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