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Atrial fibrillation symptoms and signs can vary between people, but hearing abnormal sounds coming from your heart is not necessarily one of them.

To understand this fully, you need to know the difference between atrial fibrillation and a phenomenon known as heart murmurs. Atrial fibrillation refers to an irregular heartbeat and affects at least 2.7 million people in the United States.

A heart murmur occurs when there is some kind of abnormal sound in between heartbeats.

While it is possible you may experience both atrial fibrillation and a heart murmur at the same time, one does not necessarily signal the other.

Here’s what you need to know about atrial fibrillation and heart murmurs, as well as signs to look out for.

Your heart makes sounds when it beats (those familiar “lub/dub“ sounds). These sounds can range in volume from barely audible to easy to hear with a stethoscope.

Abnormal heart sounds are called heart murmurs. A heart murmur may occur in between regular heartbeats and sound like one of the following:

  • a rasping
  • a whooshing
  • a blowing

Two types of heart murmurs exist. They include innocent and abnormal.

Anyone can experience an innocent heart murmur. They do not involve an underlying condition. Instead, you may experience an innocent heart murmur due to:

  • rapid growth (in a child)
  • pregnancy
  • exercise

Abnormal murmurs occur due to an underlying condition. You may experience additional symptoms along with the sounds. The symptoms you may experience depend on the underlying condition you are living with. Some potential symptoms you may experience include:

  • dizziness
  • shortness of breath
  • fainting
  • chronic (long-term) cough
  • bluish skin (this is an emergency)

If you experience any of these symptoms, you should consider seeing your doctor as soon as possible for an evaluation.

Are heart murmurs and atrial fibrillation the same thing?

Atrial fibrillation (also referred to as AFib) is a type of arrhythmia. An arrhythmia refers to a heartbeat that is irregular, too fast, or too slow. AFib is one of the most common types of arrhythmia.

Though AFib may seem harmless, the American Heart Association warns that it is a serious health condition. It increases your risk of other potentially deadly conditions, including:

  • Heart failure. People with AFib are twice as likely to develop heart failure.
  • Stroke. People with AFib are five times as likely to develop a stroke.

Heart murmurs are not necessarily a sign of AFib. Murmurs are related to how blood is flowing through your heart, particularly the valves that connect the chambers of your heart.

AFib, on the other hand, is related to electrical impulses that have become chaotic or disordered and result in an irregular, slow, or fast heart rate.

Heart murmurs and AFib have different causes.

Heart murmurs

Heart murmurs‘ causes can vary based on the type and the underlying condition causing them.

Innocent heart murmurs mean that you do not have any underlying structural issues with your heart or any underlying conditions. Though anyone at any time may get diagnosed with an innocent heart murmur, they are most common in:

  • pregnancy
  • thinner people
  • children

If you experience abnormal heart murmurs, it may be due to a defect in one or more of the valves in your heart. Defective valves could involve:

  • leaking
  • restricted blood flow
  • narrowed valves
  • closing early

Other underlying heart conditions may also cause heart murmurs. During diagnosis, a doctor will look for possible underlying causes and may refer you to a cardiologist or other specialist for further testing. Possible causes include:

  • certain infections, such as bacterial endocarditis
  • a congenital heart defect
  • a hole in the heart wall

Atrial fibrillation

According to the National Heart, Lung, and Blood Institute, there are two primary causes of AFib. They include:

  • issues with the electrical signals in the heart
  • changes in the tissues of the heart

AFib is associated with many conditions, including:

However, living with one or more of these conditions does not mean a person automatically has or will develop AFib. People with no other conditions may also develop AFib. This condition is called “lone Afib.“

Diagnosis of heart murmurs begins with your doctor listening to your heart with a stethoscope. This is often enough to hear the murmur and to classify it as innocent or abnormal. Specifically, a doctor listens for:

  • loudness
  • location
  • timing

If your doctor suspects an abnormal murmur, they may refer you to a specialist for further testing, which may include an electrocardiogram (EKG) or echocardiogram.

  • Electrocardiogram. An electrical snapshot of your heart that may identify arrhythmia or if your heart is enlarged.
  • Echocardiogram. An ultrasound of your heart that can demonstrate heart function, heart size, and valve function.

Diagnosis of AFib will most likely involve several steps, including:

  • physical examination
  • review of family and personal medical history
  • an EKG
  • an echocardiogram
  • other tests as needed, such as a sleep test, stress test, or chest X-ray

Your doctor will likely include tests and exams to search for underlying health conditions that may be causing the AFib.

Additionally, the testing done for Afib can help assess your risk of developing stroke in association with Afib, and it will assess if your heart structure or function has changed due to Afib.

Treatment for a heart murmur depends on the type as well as the exact cause of the murmur. An innocent murmur is harmless and requires no treatment.

Abnormal heart murmurs typically require treatment for the underlying condition. The exact treatment will vary based on the type and severity of the underlying condition. Some treatment options a doctor may recommend include:

AFib treatment often involves several factors, including:

  • lifestyle changes, such as diet, stress management, quitting smoking, and exercise
  • treatment of disordered sleep, such as sleep apnea
  • medications such as beta-blockers, calcium channel blockers, blood thinners, or others
  • surgical procedures such as placing a pacemaker, catheter ablation, surgical ablation, electrical cardioversion, or blocking off the left atrial appendage

Your treatment may vary based on the presence of other underlying conditions.

AFib and heart murmurs are two different conditions with different causes and symptoms. Though they can occur together, having one does not necessarily mean you have or will develop the other.

Heart murmurs are unusual sounds that come from the heart, typically between beats. A heart murmur may be innocent or abnormal. Abnormal heart murmurs occur due to an underlying condition, such as a defect in the heart valves.

AFib occurs when the heart beats irregularly or faster than normal. The condition can lead to more serious health conditions, such as heart disease and stroke. A person will need to treat any underlying condition and should consider taking steps to help prevent further complications.

You should see your doctor for regular physical exams and contact them if you experience symptoms that could indicate an issue with your heart.