Innocent Heart Murmur Causes

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Hello there!

Lately I've been thinking about the fact that I've had an "innocent" heart murmur for several years.

I've had an ultrasound of my heart and they didn't find anything structurally wrong at the time and hence the murmur was labelled innocent.

That however doesn't mean that it's necessarily normal imo. A heart murmur is always indicative of something, such as an increased blood flow. The question is just why I have this?

This is very typical of my body (as I suppose most people with ME/CFS experience) i.e., to have a bunch of things wrong that never amounts to anything since doctors never want to investigate any findings further, since no matter what my body is up to it's always "oh, that's nothing". But I'm not convinced personally since I believe most "faulty signals" of the body can tell us something about how we're doing.

Hence, I was wondering if anyone knows of alternative causes for having an innocent heart murmur. I've for example heard that it sometimes happens in patients with severe anemia (I don't have this even though I've had some anemic tendencies, but it has never been severe or even below the reference range - just low) and another thing could be hyperthyroidism, which I don't have either.

Are there any other things I should consider or look into? Would appreciate all and any input!
 
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Magnesium deficiency.
Thank you for the suggestion! Magnesium deficiency would make sense since I have a lot of neurological symptoms as well (RLS etc), but according to my serum magnesium, I'm not deficient. I however know there are some debate on deficiency on a cellular level, but any time I supplement (topical and oral) I don't really see a relief in my symptoms.

But I will have magnesium deficiency in mind, since I didn't know that could be a factor when you have a heart murmur.

Thank you again!
 

Garz

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chronic infection is another possibility

Babesia and bartonella both cause blocking of the capillaries in the heart muscle - and inflammation in the heart tissue - including the nerves - which leads to various heart rhythm disorders

over time they can also cause structural heart issues - endocarditis, heart valve calcification etc etc

both also cause fatigue - as in a CFS like state - typically with moderately reduced overall function

both also cause a wide range of neurological issues

testing for both is fraught with difficulties - and is typically very insensitive - so easily missed
 
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chronic infection is another possibility

Babesia and bartonella both cause blocking of the capillaries in the heart muscle - and inflammation in the heart tissue - including the nerves - which leads to various heart rhythm disorders

over time they can also cause structural heart issues - endocarditis, heart valve calcification etc etc
Thank you so much Garz! A doctor did mention endocarditis as an option once but quickly brushed it off. Wouldn't that be visible on an echocardiogram though? I had one of those and they didn't report any issues.

However, after my doctor brought up endocarditis and I read about it a bit I also realized I have two typical "janeway lesions" on my right sole which is a classic sign of endocarditis. I had wondered why I had black spots there and they really look just like janeway lesions (which I was previously unaware even existed).

But I have had the murmur for quite some time and that's why I'm thinking endocarditis is less likely, since it seems like you can't really have that for more than a year without getting serious issues from it.

I am feeling pretty dreadful most days but not dying dreadful yet.
 

Zebra

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Hi, @space8

I'm not sure where you live or what kind of health care you have access to, but I wonder if it would be possible for you to seek a second opinion from another cardiologist?

It seems like it would be reasonable to see another cardiologist and say something like:

"I have been diagnosed with an "innocent" heart murmur and I have been told I had a normal echocardiogram, but I'm concerned about my heart health and so I'm seeking a second opinion. What you think might be causing this heart murmur?"

I'm currently going through something similar with my lungs and even tho it felt awkward to seek a second opinion, this new pulmonologist reassured me it was to be expected and he has ordered a new set of tests to re-evaluate.

I wish you the best!
 
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Hi @Zebra and thank you for your thoughtful message!

It’s not so much that I’m worried about my heart. It’s more ... I wonder if it could possibly explain things? But I feel like anytime I try to inquire about something from a doctor I just get scoffed at since nothing’s ever anything.

I’ll try to ask about it during my next appointment but I have low hopes of it amounting to anything. But it could be good to make sure! I wish I’d ever met a pedagogical doctor that welcomed questions.

I really hope you get the help you need from your pulmonologist! That’s awesome to hear that you’ve been listened to!
 

Garz

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But I have had the murmur for quite some time and that's why I'm thinking endocarditis is less likely, since it seems like you can't really have that for more than a year without getting serious issues from it.
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bart can be a long term - even lifelong infection - causing no symptoms or fatal symptoms - or anything in between. it can also be relapsing and remitting with years in between. thats one of the reasons its so tricky to diagnose.

endocarditis is thought to happen more often in the early stages - but there is no fixed course
heart valve damage - causing murmurs - can be a result of long term infection - eg with calcification of the valve flaps

more recent formal studies doing PCR of tissue from heart valves and plaques have found some v strange and surprising findings.
using molecular methods that have not been avavalble previously some hitherto unknown or completely unexpected organisms have been found in these plaques -
including in one study a bacteria that normally inhabits marine molluscs and was not previously known to be a human pathogen. and in another a soil organism was found in the plaques along with more common human pathogens.

the other day i was speaking with someone who for a log time though Bart had infected their heart as they had severe arrhythmia and fatigue - plus positive tests for bart and lyme - but a doctor has now diagnosed them with rheumatic fever - infection of the heart tissue with a streptococcus species normally associated with strep throat. its a biofilm producer so conventional medicine says it cannot be eradicated and just seeks to reduce / manage symptoms.

bottom line - many organism can and do infect the heart and cause problems long term. recent research is showing many more organism can do this than are previously thought. if it were me i even with a slight murmur - i would look to get to the bottom of it.
 
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bart can be a long term - even lifelong infection - causing no symptoms or fatal symptoms - or anything in between. it can also be relapsing and remitting with years in between. thats one of the reasons its so tricky to diagnose.

endocarditis is thought to happen more often in the early stages - but there is no fixed course
heart valve damage - causing murmurs - can be a result of long term infection - eg with calcification of the valve flaps
Thank you so much for that ambitious post @Garz. I learnt a lot!

I had only ever read about acute (immediate danger) and subacute endocarditis and it always says something along the lines of "if untreated, can become fatal within six weeks to a year." So I just assumed it couldn't really present as a chronic condition.

Personally I would love to get to the bottom of it. But doctors always brush me off no matter what. I think I just look too healthy, even though I feel really bad. So they think "healthy-looking young person > heart murmur > *neglects the symptoms of severe fatigue, muscle aches, low grade fever etc. I have just mentioned* > must be all good then!

Well, I did get an echocardiogram though, so I shouldn't be too pessimistic, but since that didn't show anything I'm uncertain how I could push further?

I'm posting an unsolicited pic of my sole (sorry about that anyone who's foot phobic - it's the cut out picture at the bottom) in comparison to a case report picture of a foot with janeway lesions.

"Janeway lesions are painless, frequently haemorrhagic lesions seen most commonly on the palms and soles, particularly on the base of the thumb and little finger, and seen in infective endocarditis."

That to me seems suspicious. Or am I overinterpreting things?
casereports-2013-September-2013---F2.medium.gif

Case report foot

foot2.png


Pic of my sole
 

Garz

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a clear EKG is a good sign - it should pick up any really obvious valve issue or ongoing arrhythmia

though in the chronic lyme/bart population we often see people who experience lots of arrhythmia - then getting clear EKG's - perhaps because their arrhythmia is sporadic
on the plus side these rarely seem to be life threatening an tend to just be another odd symptom that clears up with treatment

24hr halter monitor is another option - i would have thought any conventional doc would offer that if you made enough fuss about heart symptoms experienced sporadically

ref the foot photos - i really couldn't say - there are so many things they could be

my fiancé had what looked very like the first photo - but only on the balls of the toes - came in bouts lasting a week or two - typically affecting all of the toes on one foot - except the big toe - but they were v painful indeed.
turns out bartonella does that also - so in her case that was the likely cause

you will not get proper diagnosis or care for chronic lyme or associated infections from regular doctors - they have been trained to believe it does not exist - and in many countries they can lose their licence for treating people for it. These people do not invest 7 years in training to get a good job and good salary to then put it all on the line for a single patient with what they see as a questionable diagnosis - so its well documented that in many countries they will instead prefer to put things like CFS/ME or fibromyalgia or post viral fatigue down as diagnosis -as there is no test that can prove any of these either way - and they fear repercussions of even mentioning lyme or any other tick borne disease.

i also spoke to someone recently who had heart symptoms and fatigue over many years - waxing and waning - a doctor now tells them they suspect "rheumatic fever" which is a bacterial infection of the heart caused by a streptococcus species - it is a chronic condition that damages the heart over time - it normally has an onset a few weeks after a bout of strep throat - as its that bacteria that gets into the heart and causes damage.
https://www.nhs.uk/conditions/rheumatic-fever/

i think there are tests for that one - might be worth looking into

so there are a lot of things out there that can cause these type of symptoms - not just innocent murmur / or lyme etc al / or else its nothing

failing that - private tests are available for Lyme Bart etc - testing is not perfect - but mostly down to sensitivity issues - false positive rates are much lower than false negatives( 5-8x lower) - so a positive result is much more diagnostic - tests can also be combined for a better evaluation - eg WB, LTT, CD57+
i dont know where in the world you are -
Igenex in the USA and Armin labs in Europe are the most respected private Tick borne disease testing labs
 
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