Heart Murmur vs. Irregular Heartbeat: What’s the Difference?

The heart’s rhythm is controlled by the sinus node—its natural pacemaker—which produces the electrical signals responsible for each heartbeat. Depending on the activity, a healthy, normal heartbeat is between 60 and 100 times per minute.

When you hear or feel irregular heartbeats or cardiac murmurs for the first time, they can both appear concerning. Heart murmurs are noises produced by the heart’s rapid, choppy (turbulent) blood flow, such as whooshing or swishing.

However, palpitations, which feel like the heart is skipping, fluttering, or beating too forcefully or too quickly, can occur when electrical irregularities result in arrhythmia, or abnormal heart rhythms. A person experiencing an arrhythmia might notice these kinds of sensations in the chest, throat, or neck. Fainting may result from extremely severe heart rhythm disorders.

Even though in both cases the heart is involved, the two disorders are quite distinct from one another. To safeguard your heart health, this article explains the main distinctions, typical symptoms, and—above all—when to consult a doctor.

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What Is a Heart Murmur?

Blood flows through valves that open and close in response to heartbeats. When heart valves close, they create two sounds often said as ‘lub’ and ‘dub.’

A cardiac murmur occurs when your heart produces a whooshing or swishing sound. A murmur indicates that your heart valves are not allowing blood to circulate correctly. Heart murmurs may be present during birth (congenital) or it can also develop over time during a person’s life.

A murmur could indicate a cardiac condition. However, heart murmurs, often known as “innocent” heart murmurs, can occur in healthy individuals without a cardiac condition. Certain cardiac murmurs are not harmful.

An additional heart murmur could indicate significant heart disease. To examine the heart valves, some tests are required. The reason determines the course of your treatment for heart murmurs.

Common causes: A heart murmur occurs when blood flows through the heart in a fast and irregular (turbulent) manner. A heart murmur could occur:

• A diastolic murmur happens as the heart fills with blood during the relaxation phase
• The systolic murmur, which occurs when the heart is emptying
• All during the heartbeat (constant murmur)

In most cases, someone with an innocent heart murmur is said to have a healthy heart. These kinds of harmless heart murmurs are usually found in infants and young children. The following factors could alter blood flow and result in an innocent heart murmur:

• Work out
• Pregnancy
• The initial days following a baby’s birth
• Fever
• Periods of fast growth, like adolescence

How it’s diagnosed: By listening to your heart, a medical practitioner can identify a heart murmur. A murmur is a strange swishing sound. A doctor pays attention to specific aspects of your heartbeat:

• Instead of swishing, make a lub-dub sound
• Pitch
• Timing
• Rhythm
• Volume

They can ask the person to hold their breath or shift postures to get a better picture of the condition. Certain heart murmurs become more or less noticeable when a person is crouching, as opposed to standing, or when they are breathing, as opposed to holding their breath.

“The most important test for a heart murmur is a careful exam with a stethoscope,” says cardiologist John Fahey, MD, director of Yale Medicine’s Adult Congenital Heart Program. “If your doctor determines that the murmur is innocent, no further testing is needed. You may participate in all activities with no concerns or restrictions.”

What Is an Irregular Heartbeat (Arrhythmia)?

An irregular heartbeat is called a heart arrhythmia (pronounced “uh-RITH-me-uh”). When the electrical signals that instruct the heart to beat malfunction, a cardiac arrhythmia results. The heart may beat too quickly or too slowly. Alternatively, the heartbeat’s rhythm could be irregular.

An arrhythmia of the heart can resemble a rapid, hammering, or fluttering heartbeat. Certain cardiac arrhythmias are not harmful. Others could result in fatal symptoms.

In some cases, a fast or slow heartbeat can be considered normal. For instance, the heart may beat more slowly when you sleep or more quickly when you exercise.

“These sensations are fairly common and often not harmful,” says Jane Henoch, FNP-BC, a Mass General Brigham nurse practitioner. Henoch cares for patients at Massachusetts General Hospital and specializes in cardiac arrhythmias, or irregular heartbeats.

But persistent or frequent irregular heartbeats may require medical care, especially if they occur with other symptoms. “Certain arrhythmias can be serious and even life-threatening if not treated,” says Henoch.

Standard types: The speed of the heartbeat is used to categorize the various types of arrhythmia.

• AFIb, or Atrial Fibrillation: A fast, erratic heartbeat is the result of chaotic heart signals. AFib may be transient and occur spontaneously. However, without treatment, specific episodes could not end. AFib has been linked to stroke.
• Fluttering of the Atrium: Although AFib and atrial flutter are similar conditions, atrial flutter typically causes a more consistent heart rhythm. Stroke is also associated with atrial flutter.
• Supraventricular Tachycardia: This general phrase encompasses irregular heartbeats that originate above the ventricles, which are the lower heart chambers. Sudden onset and cessation of a hammering heartbeat are symptoms of supraventricular tachycardia.
• Ventricular Fibrillation: Rapid and chaotic electrical impulses cause the lower chambers of the heart to quiver rather than to contract together. This dangerous condition could be fatal if you don’t restore a normal cardiac beat within minutes. Most individuals with ventricular fibrillation have previously experienced serious trauma or suffer from existing heart conditions.

Symptoms may include: In addition to a racing or fluttering feeling in the heart, other signs of an arrhythmia may consist of:

• Exhaustion
• Lightheadedness
• Dizziness
• Bouts of fainting (syncope) or near fainting
• Palpitations can feel like your heart is pounding or fluttering in your chest
• Breathlessness
• Chest discomfort

Read More: Is It Normal for Your Heart Rate to Fluctuate While Resting?

Key Differences Between Heart Murmur and Irregular Heartbeat

Can You Have Both a Murmur and an Arrhythmia?

Heart murmurs and atrial fibrillation are separate conditions, each with its own set of symptoms and underlying causes. Having one does not guarantee that you have or will develop the other, even though they can happen together.

Unusual sounds produced by the heart, usually in between beats, are known as heart murmurs. There are two types of cardiac murmurs: benign and aberrant. An underlying problem, such as a heart valve defect, might cause abnormal heart murmurs.

An irregular or accelerated heartbeat is known as atrial fibrillation (AFib). More severe illnesses, including heart disease and stroke, can result from the syndrome. In addition to treating any underlying conditions, a person should think about taking precautions to help avoid such problems.

You should schedule routine physical examinations with your physician and get in touch with them if you have any symptoms that might point to a cardiac condition.

When to See a Doctor

If you suffer from heart murmurs:

If you suffer from enduring symptoms like:

• Chest discomfort
• Breathing difficulties
• Inexplicable exhaustion
• Lightheadedness or edema

These should be cause for concern, particularly as an adult. Furthermore, any adult who develops new symptoms or discovers a cardiac murmur should get help right away. People with hyperthyroidism, marked by an overactive thyroid, should exercise special caution because it may cause additional heart sounds that could indicate a problem.

If you have an irregular heartbeat:

Heart rhythm specialist Charles Rouse, MD, who serves patients in Fairfield and New Haven Counties, notes, “We start to get more concerned when palpitations happen more frequently, or the episodes are longer.”

Talk to a doctor if you have palpitations:

• Occur repetitively: Multiple times a week;
• Last several minutes: For example, at least ten minutes.

Seek an appointment for some type of cardiac evaluation if either of the prior situations applies, even if the prolonged episode was an isolated incident.

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Treatment Options

Heart Murmurs:

There is no need for therapy if a cardiac murmur is determined to be “innocent” or innocuous. When a heart murmur is abnormal, addressing the underlying health condition is essential for proper treatment. Typical therapies consist of:

Anti-arrhythmic drugs can aid in the heart’s recovery to a more regular rhythm.

ACE inhibitors, commonly known as ARBs, can help a person with high blood pressure lower their blood pressure levels. They can also occasionally aid people with heart murmurs.

Blood thinners can reduce the chance of blood clots forming in the heart in people with malfunctioning heart valves.

Antibiotics are used to treat bacterial infections that might induce heart murmurs.

Cardiac catheterization or surgery can replace or repair a heart valve or seal the hole in the heart wall.

Irregular Heartbeats:

Once they make the diagnosis and complete additional relevant testing, doctors choose the appropriate treatments for each patient. In mild cases of cardiac arrhythmia, they may treat the condition with lifestyle modifications. Other people might require treatments like ablation, which involves the chemical or surgical removal of aberrant heart structures.

Medication might be the best option for certain arrhythmias.  It can be necessary to implant a device to control the heart rhythm from inside the body in cases of life-threatening arrhythmias.

For instance, people with hazardous rhythms from the ventricle, the lower chamber of the heart, may need an implanted defibrillator, while those with severe bradycardia may need a pacemaker.

Read More: Signs of a Heart Attack That Could Show Up a Month Before

Final Thoughts

Irregular heartbeats and heart murmurs may be alike, but are fundamentally different when it comes to the heart and how it operates. The heart’s rhythm determines an irregular heart rate, and the way blood flows through the heart determines a murmur.

All health concerns are serious concerns, and these conditions are no exception (especially if you have experienced fatigue, dyspnea, or irregularities like fluttering or skipped beats). These could be signs of a heart issue and may warrant concern.

Luckily, you can get to the bottom of these issues and avoid serious health problems with early detection and treatment. Seeing your doctor can ensure that you maintain a healthy heart and can offer peace of mind.

If you have concerns about your heart, do not hesitate to consult with your doctor. Overall, it is better to be safe than sorry when it comes to your heart.