question-icon

What are the chances of missing heart murmurs in a medical examination?

default
Posted on Fri, 13 May 2016
Question: Hi there,
My son is having a pacemaker implanted in the next few weeks for a complete heart block. He is nearly 4.

I have 2 questions.

Firstly, a Dr diagnosed him as also having a soft murmur a couple if months ago, the we saw his cardiologist s couple of weeks later, who stated there was nomurmur, then last week we saw yet another Dr who again found a murmur. Can murmurs come and go within this short space of time, or did his cardiologist miss it?

Secondly, the cause of my son's heart block is still a mystery. He was born 6 weeks early and as such, I would have thought it would have been picked up then, instead it was found when doing his routine obs when he had an ENT virus when he was 2.

I had a tick bite a while before getting pregnant, which was removed carelessly. I have never had a Lyme Disease test, but understand this can be passed through the placenta and can cause complete heart block. Should this not be explored before pacing him, as I understand antibiotics can reverse heart blocks from Lyme Disease, or would it be too late for antibiotics to be of any use?

Kind Regards
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would like to explain that heart murmurs in children can fluctuate, especially when they occur in a normal heart (resulted from the cardiac ultrasound). These are also called innocent murmurs.

From the other hand a heart block at this age could be congenital from the birth, related to hypoxia or any other other defects during the creation of his heart tissues in the embrional-fetal life.

Regarding Lyme disease in pregnant females and its effects on the fetal there are insufficient data based evidence to support this possible relation between this infection and congenital heart disorders.

Nevertheless, I would recommend performing Lyme-antibodies test, before proceeding to the pacemaker.

Hope you will find this answer helpful!

Feel free to ask any other questions, whenever you need!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 8356 Questions

premium_optimized

The User accepted the expert's answer

Share on
What are the chances of missing heart murmurs in a medical examination?

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! Regarding your concern, I would like to explain that heart murmurs in children can fluctuate, especially when they occur in a normal heart (resulted from the cardiac ultrasound). These are also called innocent murmurs. From the other hand a heart block at this age could be congenital from the birth, related to hypoxia or any other other defects during the creation of his heart tissues in the embrional-fetal life. Regarding Lyme disease in pregnant females and its effects on the fetal there are insufficient data based evidence to support this possible relation between this infection and congenital heart disorders. Nevertheless, I would recommend performing Lyme-antibodies test, before proceeding to the pacemaker. Hope you will find this answer helpful! Feel free to ask any other questions, whenever you need! Kind regards, Dr. Iliri