Is it Safe to Continue Your Athletic Journey with a Heart Murmur?


Imagine your heart as a machine with four rooms and four special doors. Its main duty is to ensure that blood flows in just one direction. These special doors are like gates that open only one way, allowing your blood to travel to the next room or into the big blood highways of your body. So when your doctor listens to your heart, they hear a “lub-dub” sound, like a gentle thump. But sometimes, they might also catch a “whoosh” or “swish” sound, like a soft rushing noise. This happens when the blood doesn’t flow smoothly near your heart. It’s called an athletic heart murmur.

Heart murmur in athletes

During a sports check-up, a heart murmur, which is like a swishing noise when blood doesn’t flow smoothly in the heart, might come up. This can make you wonder if it’s safe to keep playing sports. To figure out if you can play sports as an athlete with a heart murmur, you need to consider a few things:

  • When the murmur started: Was it there since you were born?
  • What’s causing the murmur: Why is it happening?
  • Other symptoms: Do you have any other problems?
  • Test results: What do the tests say about your heart?

Should athletes with heart murmurs be concerned?

In athletes, many heart murmurs are known as “physiological” or “innocent” murmurs. These murmurs don’t mean your heart is sick; in fact, they can be a sign that your heart is getting even healthier from all that exercise.

When you regularly do intense endurance workouts, your heart can change a bit. It might get a little bigger, and this helps it pump more blood with each beat. When your doctor listens to your chest with a stethoscope, they might hear this increased blood movement, which they call “stroke volume.” This is more common in young athletes and those who do a lot of aerobic exercise.

However, that whooshing sound can also point to a heart issue.

This murmur might be a result of turbulent blood flow caused by problems with one or more of your heart valves. In rarer cases, it could be due to a tiny hole in your heart or a condition called hypertrophic cardiomyopathy. This condition makes your heart muscle thicker than it should be and can slow down the blood moving from your heart to the main blood vessel, the aorta.

So, when your doctor hears a heart murmur, it’s crucial to figure out why it’s happening. Is it just a harmless sound? Or does it signal an abnormal heart condition? In some rare cases, a murmur could be a warning sign of a more significant problem that might put an athlete at risk of sudden cardiac issues or other health troubles.

Your doctor should be able to distinguish between a normal murmur (nothing to worry about) and one that needs further investigation based on when and how the murmur happens.

Physiological vs Pathological athletic heart murmur

Getting your heart in great shape from exercising a lot can bring about changes in your heart muscles that lead to a harmless murmur. This is more common in young athletes and those who do a lot of endurance workouts. These changes can include:

  • A slower heart rate
  • A type of murmur called a systolic ejection murmur in the upper left ventricle
  • A third heart sound
  • The point where your heart beats the hardest moving to the side
  • More blood circulating through your body

However, heart murmurs that are not due to fitness but are because of underlying problems can be a sign of a higher risk of sudden heart issues. Some factors that can lead to an abnormal heart murmur include:

  • Cardiomyopathy
  • High blood pressure
  • High blood pressure in the lungs
  • Hyperthyroidism
  • Heart disease
  • Endocarditis (an infection in your heart)
  • Valve calcification (hardening of your heart valves)
  • Autoimmune disorder

Congenital vs recent heart murmur in athletes

If you’re an athlete and have had a heart murmur since birth, it’s probably not because of sports. It might be due to a hidden issue in your heart. Congenital heart problems can sometimes lead to sudden heart attacks in kids. These problems can involve:

  • A hole in the heart
  • Cardiac shunts (abnormal connections in the heart)
  • A heart valve that’s too narrow or leaks
  • Hypertrophic cardiomyopathy, which means your heart muscle is too thick

So, if you’ve had a heart murmur from the start, it’s essential to figure out what’s causing it, as it might not be related to your athletic activities.

Can you still play sports with a heart murmur?

In most situations, having a heart murmur shouldn’t stop you from enjoying sports, as long as you take steps to look after your health. If you’re an athlete with a heart murmur, here are some things to consider:

  • Treatment options: If your heart murmur needs treatment, your choices could include medications, surgery, or changes in your diet. It depends on what’s causing the problem. Surgery might be needed if you have a hole, leaky valve, or a narrow valve. On the other hand, managing high blood pressure might only require dietary changes.
  • Consult a sports cardiologist: Sometimes, a heart specialist for athletes might suggest you reduce the intensity of your exercise or explore other hobbies that don’t involve strenuous physical activity.
  • Safety first: Whether you continue playing sports or not, it’s a smart move to have an automated external defibrillator nearby whenever you engage in physical activities. You never know when an undetected heart issue might lead to a sudden cardiac arrest, and having a defibrillator on hand could save a life.

Determining an athletic heart murmur for better sports performance

Whether you’re a seasoned athlete or just starting, understanding the nature of your heart murmur is crucial. If it’s a harmless, exercise-induced murmur, embrace your active lifestyle and keep working on your fitness. Remember, safety should always come first. Consider having an automated external defibrillator readily available during physical activities to ensure you and those around you are prepared for any unforeseen cardiac issues. Your heart’s rhythm may have a murmur, but with the right precautions and care, your athletic journey can continue strong.


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