You have a heart murmur, but now what? There are different kinds of treatments for different severities of murmurs. Usually it is a simple treatment, but if not, there are other options. And how has COVID-19 had an impact on patients with heart murmurs and how doctors treat the condition? Experienced consultant cardiologist Dr Aigul Baltabaeva clarifies these unknowns.
What are the treatments for heart murmurs?
If a murmur is heard by a GP, the patient will then go see a cardiologist and do a very simple test called echocardiography. This can be done as many times as needed as it has no radiation whatsoever. It lasts about 30 minutes and uses ultrasound waves sending vibrations to get a picture of the heart ruptures and red blood cells, easily identifying the grade and severity of the valvular heart problem.
However, not every heart murmur requires treatment. If a cardiologist detects a significant valve disease or heart structural disease, they would create a management plan. Majority of murmurs only need medical therapy pills to help flow blood through the heart or water tablets to reduce the load on the heart muscles so it can pump properly. Although, surgery is required if the severity of the disease is causing problems with heart function.
Lately, there has been development of both surgical and non-surgical keyhole intervention, where the non-surgical intervention involves a catheter delivered technique. In general, options for patients with this heart valve disease are increasing more and more. As opposed to doing a big open-heart surgery, more surgeons have been developing techniques where they deliver minimal access heart valve repairs and replacements through a small incision.
If a patient is considered for surgery, they need to undergo a vast workup to make sure that other health-related conditions are fully assessed. It is not a decision taken lightly by one person, and currently, a multidisciplinary approach is used. Operations are not needlessly done.
How are heart murmurs affected by COVID-19?
The good news is that as far as COVID-19 goes there is not much effect on most heart murmurs.
However, those with severe symptomatic heart valve disease who have some complications causing great pressures in the lungs are at higher risk of getting a severe form of COVID-19. As should be the case with everyone, this group of patients in particular should get double-vaccinated and still adhere to social protective measures, as vaccination is not guaranteed against COVID-19. The same applies to patients who have had recent heart valve surgery because it takes up to three months to recover and they have to be cautious.
The bigger, indirect problem cause by COVID-19 is actually an increased waiting time for surgery as all the resources of the NHS are redirected to treat patients with coronavirus infection, including reduced access to healthcare and diagnostics. This is going to be a big problem before we catch-up and see everyone with serious heart murmurs causing complications and decompensation.
My message to patients is if you are having the symptoms I’ve described in my other article – short breath, chest pain, dizziness, or feeling unwell generally – go and see your GP.
With COVID-19, I am a principal investigator with a study about mitral regurgitation inaccurate heart failure. In a relatively large district general hospital in Surrey, we’ve been following up patients who have presented with acute heart failure and their leaky valve on the left side to see what happens to them over some years now. We are planning this year to reanalyse the data and see what happened to these patients during the COVID-19 pandemic. We will have a better idea of the impact of COVID-19 on those with significant valve problems and heart failure.
If you are unsure about your heart condition or think that you may be experiencing heart murmurs, you can go to Dr Baltabaeva's profile and book a consultation.