Diastolic Heart Murmur: Symptoms, Diagnosis and Treatment

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About Diastolic Heart Murmur

Diastolic heart murmur differs from systolic heart murmur in that diastolic heart murmur commonly is an indicator that heart disease is present.

Symptoms

For many patients, diastolic heart murmur will be diagnosed not due to initial complaints of symptoms from the patient, but due to the discovery of the murmur during routine medical exam.

When symptoms are present, they include heart palpitations, dyspnea (difficulty in breathing), chest pain, hoarseness, frequently occurring respiratory infections, edema, weight loss, rash and fever.

Diagnosis

When diagnosing diastolic heart murmur, the patient’s medical history may be considered. Certain conditions can be indicators because they can cause diastolic heart murmur.

Some of the conditions the physician will look for in the patient’s medical history include rheumatic fever, endocarditis, congenital heart malformations, pulmonary hypertension, syphilis, atrial myxoma, collagen vascular disease and connective tissue disease.

Physical exam and testing can also be part of the diagnosis process. In the physical exam, the location of the murmur is one consideration, as is whether the murmur varies from exam to exam.

An echocardiogram is generally the test used to diagnose diastolic heart murmur. Typically, transthoracic echocardiography is used, but if it is suspected that endocarditis is present, a transesophageal echocardiography test may be used instead.

Additionally, an MRI or computed tomography may be used in the diagnostic process.

Lab testing that may be used will be to identify underlying causes such as syphilis.

Treatment

The treatment used for the heart murmur will depend on several factors, including the cause. In some cases, medication such as Digoxin, anticoagulants, diuretics, statins or ACE-inhibitors may be used. In others, a ‘wait and see’ approach may be used.

In some cases, the recommended treatment may be surgery or catheterization. These options will be used if there is a hole in the heart that needs to be repaired, a valve needs to be repaired or replaced, a blood vessel needs to be rebuilt, a blood vessel needs to be widened and in other similar circumstances.

Summary

Diastolic heart murmur differs from systolic heart murmur because it usually indicates heart disease, but is similar in other ways. While an innocent (harmless) heart murmur does not usually merit concern, an abnormal heart murmur may require monitoring, drug treatment or surgery.

Additionally, depending upon the cause, symptoms may not be present with diastolic heart murmur, in much the same way as they may not be present with systolic heart murmur. Symptoms, when present, may indicate heart murmur or any of a number of other medical concerns.

References

Heart Murmur, Diastolic. Excerpt from The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Line Encounter. Davide E. Anisman and Gerald F. Farnell. https://www.wrongdiagnosis.com/h/heart_disease/book-diseases-10c.htm

Heart Murmurs. Mayo Clinic Staff. April 9, 2010. https://www.mayoclinic.com/health/heart-murmurs/DS00727