Treatments and drugs

By Mayo Clinic Staff

An innocent heart murmur generally doesn't require treatment because the heart is normal. If innocent murmurs are the result of an illness, such as fever or hyperthyroidism, the murmurs will go away once that condition is treated.

If you or your child has an abnormal heart murmur, treatment may not be necessary. Your doctor may want to monitor the condition over time. If treatment is necessary, it depends on what heart problem is causing the murmur and may include medications or surgery.

Medications

The medication your doctor prescribes depends on the specific heart problem you have. Some medications your doctor might give you include:

  • Medications that prevent blood clots (anticoagulants). Your doctor may prescribe anticoagulants, such as aspirin, warfarin (Coumadin, Jantoven) or clopidogrel (Plavix). An anticoagulant prevents blood clots from forming in your heart and causing a heart attack or stroke.
  • Water pills (diuretics). Diuretics remove excess fluid from your body, which can help treat other conditions that might worsen a heart murmur, such as high blood pressure.
  • Angiotensin-converting enzyme (ACE) inhibitors. ACE inhibitors lower your blood pressure. High blood pressure can worsen underlying conditions that cause heart murmurs.
  • Statins. Statins help lower your cholesterol. Having high cholesterol seems to worsen some heart valve problems, including some heart murmurs.
  • Beta blockers. These drugs lower your heart rate and blood pressure. They're used for some types of heart valve problems.

Surgery

Many valve conditions can't be treated with medications alone. Depending on your heart condition, your doctor may recommend one of these options to treat a damaged or leaky valve:

Valve repair

To repair a valve, your doctor may recommend one of the following procedures:

  • Balloon valvuloplasty. This procedure is performed to relieve a narrowed valve. During a balloon valvuloplasty, a small catheter containing an expandable balloon is threaded into your heart, placed into the valve and then expanded to help widen the narrowed valve.
  • Annuloplasty. In this procedure, your surgeon tightens the tissue around the valve by implanting an artificial ring. This allows the leaflets to come together and close the abnormal opening through the valve.
  • Repair of structural support. In this procedure, your surgeon replaces or shortens the cords that support the valves (chordae tendineae and papillary muscles) to repair the structural support. When the cords and muscles are the right length, the valve leaflet edges meet and eliminate the leak.
  • Valve leaflet repair. In valve leaflet repair, your surgeon surgically separates, cuts or pleats a valve flap (leaflet).

Valve replacement

In many cases, the valve has to be replaced. Options include:

  • Open-heart surgery. This is the primary surgical treatment for severe valve stenosis. Your surgeon removes the narrowed valve and replaces it with a mechanical valve or a tissue valve.

    Mechanical valves, made from metal, are durable, but carry the risk of blood clots forming. If you receive a mechanical valve, you'll need to take an anticoagulant medication, such as warfarin (Coumadin, Jantoven), for life to prevent blood clots.

    Tissue valves — which may come from a pig, cow or human deceased donor — often eventually need replacement. Another type of tissue valve replacement that uses your own pulmonary valve (autograft) is sometimes possible.

  • Transcatheter aortic valve replacement (TAVR). A less invasive approach, TAVR involves replacing the aortic valve with a prosthetic valve via an artery in your leg or in a small incision in your chest.

    In some cases, a valve can be inserted via a catheter into a tissue replacement valve that needs to be replaced (valve-in-valve procedure).

    TAVR is usually reserved for individuals with severe aortic valve stenosis who are at increased risk of complications from aortic valve surgery.

Doctors used to recommend that most people with abnormal heart murmurs take antibiotics before visiting the dentist or having surgery due to possible complications from a bacterial infection that affects the lining of your heart (infective endocarditis).

Doctors no longer recommend antibiotics before procedures, except for people at highest risk of complications of infective endocarditis, such as those who have an artificial heart valve or people with certain congenital heart defects.

April 03, 2015

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