Running with a Heart Murmur – The Complete guide

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Cross Training For Runners
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David Dack

Runners have great hearts.

I mean, for real. After logging thousands of miles over the years, a runner’s heart might have bigger arteries, more copious coronary capillaries, and more flexible coronary arteries than the average joe.

I hate to sound like a broken record, but running is an excellent cardiovascular exercise. It helps you burn calories, improve endurance, and get in the best shape of your life.

But if you have heart murmurs, high-intensity training can be uncomfortable and maybe dangerous.

So what causes heart murmurs?  are you in danger? That’s where today’s post comes in handy.

In today’s article, I’ll examine whether you should run with a heart murmur and what to do about this cardiovascular condition.

The Anatomy of your Heart

The heart is undoubtedly one of the most important organs in your body.

Made up of chambers and valves, your heart has one of the most important jobs: to keep your blood flowing throughout your body.

The heart has four chambers, two upper chambers (atria) and two lower chambers (ventricles). Circulation flows through a valve before leaving each chamber of the heart. These valves function as guards that prevent the backward flow of blood.

Yes, it’s an amazing design.

What Are Heart Murmurs?

Before I get into whether you should run with a heart murmur, let’s first define what a heart murmur is to ensure we’re on the same page.

A heart murmur, in short, is the sound made by turbulent blood flow within your heart. This is often triggered by a change in circulation through one of the heart valves. The murmur can be a rasping, blowing, or whooshing sound during a heartbeat.

In other words, it’s an abnormal noise between heartbeats.

Most heart murmurs are benign—common in children and young adults. But at times, they might indicate serious heart problems (more on later).

So what’s causing the switch in blood flow within the heart valves? And is it a sign of a serious problem in the heart?

Here’s the good news.

Heart murmurs can strike both healthy and sick hearts.  Changes in blood flow are often a normal thing in a normal heart—or what’s known as a benign flow murmur.

In most cases, the change in blood flow within the heart can be caused by fever, stress, anxiety, anemia, or an elevated heart rate after a run. In addition, roughly 10 percent of adults and 30 percent of children experience benign murmurs at some stage.

Benign Vs. Abnormal Heart Murmurs

Heart murmurs can be divided into two kinds:

  • Benign
  • Abnormal

As the name implies, benign murmurs aren’t dangerous.

In some people, benign murmur can be caused by pregnancy, intense exercise, severe anemia, or fever.

If you have a benign heart murmur, you won’t experience any other symptoms.

However, When a serious heart condition causes a heart murmur, you may experience other symptoms such as:

  • Chest pain
  • Shortness of breath
  • Dizziness
  • Fainting
  • Enlarged neck veins
  • Chronic coughing
  • Profuse sweating, especially when you’re done running.
  • Blue skin around the lips and fingertips
  • Cold clammy skin

These symptoms may indicate a serious underlying heart condition that hasn’t been diagnosed.

If you’re coming down with any of these symptoms while running and/or at rest, call 911 immediately. You need to get checked up right away. Don’t dilly-dally.

Heart Murmurs In Runners

In most cases, heart murmurs in runners are of the “innocent” variety. The whooshing sound is blood flowing through a normal, healthy heart.

What’s more?

They might indicate an improved cardiovascular function instead of a dangerous heart abnormality. As you get fitter and stronger—especially aerobically, your heart might adapt by somewhat enlarging. This, in turn, allows moving more blood on each contraction.

What the Latest Research Says About Exercising with a Heart Murmur

Staying active with a heart murmur can be safe and beneficial, but it’s always wise to stay informed on the latest recommendations. Here’s a look at recent studies and expert advice from reputable health organizations on exercising with a heart murmur.

 Exercise is Often Encouraged for Innocent Murmurs

According to the American Heart Association (AHA), those with innocent heart murmurs can typically continue regular physical activity, including running, without any restrictions. In fact, the AHA notes that exercise is beneficial for overall cardiovascular health, helping to maintain heart strength and efficiency. However, it’s still important to check with your doctor to confirm that your murmur is indeed innocent and safe to exercise with.

Abnormal Murmurs May Require More Caution

For runners with abnormal murmurs, guidelines are a bit more cautious. A recent study published in the Journal of the American College of Cardiology recommends that individuals with certain heart conditions, including some types of abnormal murmurs, undergo thorough medical screening before engaging in high-intensity exercise. This often includes tests like an echocardiogram or stress test to assess heart function under exertion.

When To Consult A Doctor

I hate to sound like a broken record, but most heart murmurs are not a threat unless you experience any abnormal symptoms; consult your doctor immediately.

The examination—preferably by a cardiologist—will likely include an echocardiogram, which examines the function of your heart muscles and valves.

By doing this, they can determine if your heart murmurs are benign or if they do require medical attention.

In some cases, a heart murmur could be a sign of a problem with your heart. This problem can either result from an abnormal function within the heart or a structural abnormality in one of the heart valves or chambers.

For example, hypertrophic cardiomyopathy, which is a condition that causes an abnormal thickening of the heart muscle, can also result in murmurs. This condition can limit or block blood flow from the heart’s left ventricle to the aorta, your body’s main blood vessel.

For these reasons, and some more,  if you have a heart murmur, it’s key to get to the root of the sound. Is it innocent? Or is it caused by abnormal pathology? It’s always better to safe than sorry, you know.

Additional resource – Prevent Heart Burn In Runners

How To Treat A Heart Murmur

Treating a heart murmur depends on the main cause. Benign heart murmurs don’t require any treatment, but dangerous ones need medical attention ASAP, especially if you have symptoms like those listed below.

  • Shortness of breath
  • Ankle swelling
  • Chest pain
  • Sudden weight gain
  • Fever or night sweats
  • Extreme exhaustion
  • Fainting or dizziness
  • Chronic fatigue

Most of the latter are typically treated with medication. However, serious conditions could require surgery.

Some of the most common medications used for managing and treating abnormal heart murmurs include:

  • ACE inhibitors or Beta Blockers—work great for lowering blood pressure.
  • Statins—work great for managing cholesterol.
  • Aspirin or warfarin is an anticoagulant to help prevent blood clots from forming.

Surgery is needed in extreme cases, especially when medication isn’t enough. For example, if one of your heart valves needs to be replaced or has a hole in your heart, you’ll need surgery.

Running With A Heart Murmur

Getting diagnosed with a heart murmur may scare most people from running.

However, most cases are benign, therefore, shouldn’t prevent you from running. But it’s always recommended to get checked by a cardiologist to ensure you understand the cause of the murmur. Then, once you have your doctor’s green light, go back to training.

As I’ve explained in this article, it’s not always the case, and most runners can keep on training when experiencing heart murmurs.

To err on the side of caution, do the following:

  • Consult your doctor to understand the cause of the murmur
  • Check the history of heart disease in your family
  • Stick to a healthy nutrition plan
  • Get a yearly electrocardiogram or chest X-ray
  • Learn how to train by heart rate zones
  • Run regularly
  • Follow proper recovery practices
  • Listen to your body

Preventative Measures For Running With Heart Murmurs

It’s always better to err on the side of caution. So take the following measures to ensure your cardiovascular health is checked, even if you feel healthy.

  • Look into whether your family has a history of cardiovascular conditions
  • Learn how to monitor your pulse during training for rate and regularity. I’d recommend that you learn how to use heart rate training zones.
  • Get a general annual exam, including a chest X-Ray and an electrocardiogram (ECG).
  • Keep a healthy diet
  • And most importantly, keep running. It does your heart good but doesn’t push yourself too hard.

Risk Factors For Heart Murmurs

You’ll be more prone to heart murmurs if someone in your family has some form of heart problem associated with the unusual sounds.

Some of these conditions include:

  • Endocarditis, which is an infection of the lining of the heart
  • Cardiomyopathy, which is the weakening of the heart muscle
  • Hypereosinophilic syndrome is a blood condition that involves an increased number of certain white cells.
  • Some autoimmune conditions, such as rheumatoid arthritis and lupus.
  • Heart valve diseases
  • Hyperthyroidism is an overactive thyroid.
  • Rheumatic fever
  • Pulmonary hypertension, which is high blood pressure in the lung

Share Your Heart Health Tips!

Managing a heart murmur while staying active can be a unique journey, and every runner’s experience is different. We’d love to hear your stories and any tips you’ve discovered along the way. Whether it’s a pacing strategy, a favorite way to track your heart rate, or advice from your doctor, your insights could be just what another runner needs.

Have You Managed a Heart Murmur While Staying Active?

Jump into the comments and share your experience! 

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