Once you have identified which murmur…
- A murmur is (technically) NOT a diagnosis but a sign. Therefore you should ask WHY is there a murmur. This may involve further investigation e.g.
- Echocardiogram – will often further evaluate the severity and impact of a murmur but may not provide a cause.
- Imaging- e.g. CTPA (particularly if SOB and pulmonary regurgitation- to rule out PE as cause)
- ECG- may show signs of past infarction which may explain a murmur
- Management of murmurs really depends on the underlying cause and whether it is reversible. It also depends on the impact of the murmur on cardiac function. A large number are managed conservatively (particularly idiopathic aortic stenosis), although it is a good idea to manage any underlying risk factors for cardiac disease e.g. cholesterol, blood pressure, weight, etc.