Anxiety can cause all sorts of cardiovascular symptoms: racing heartbeat, rapid breathing, and chest pain. But can it cause a heart murmur?

Although typically not listed as a cause, according to the Better Health Channel, emotional stress can increase blood flow and interfere with the force of your heartbeat. And this can potentially cause a physiologic heart murmur.

According to Harvard Medical School, if you’re anxious, you may be more likely to have a heart murmur. Anxiety, according to the Anxiety and Depression Society of America is a reaction to stress.

Read on to learn more about heart murmurs and how stress can affect your overall cardiovascular health.

How can stress affect your heart? 

While there’s limited information out there about how stress is connected to heart murmurs, stress has been known to increase the likelihood of certain behaviors and events that play a role in negatively affecting heart health. 

These behaviors and events include smoking, overeating, and bodily responses like an increase in cortisol levels, which can lead to an increase in blood pressure.

Stress is also known to create anxiety, which is connected to physiologic heart murmurs.

What exactly is a heart murmur?

Harvard Medical School describes a heart murmur as the sound of turbulent blood flow within your heart. When a doctor using a stethoscope hears an unusual sound between heartbeats, this can often represent that turbulent flow from a heart murmur .

If your heart doesn’t have a murmur, the doctor will hear your blood flowing through your heart with a rhythmic “lub dub” sound. 

If your heart does have a murmur, your doctor will hear a “whooshing” or “swishing” sound, which occurs between the “lub dub” sounds. It can happen when your heart squeezes (systolic murmur) or when it relaxes (diastolic murmur). Diastolic murmurs are almost always abnormal or pathological.

There are 2 types of heart murmurs:

  • Flow murmur (also called functional or physiologic)
  • Abnormal (also called pathological)

Physiologic heart murmurs 

When blood flows through your heart more rapidly than normal, the sound it makes is referred to as a flow murmur or physiologic murmur. 

Physiologic heart murmurs can go away on their own, depending on the underlying condition causing the flow murmur. They can also last your whole life without causing health problems. 

According to the American Heart Association, physiologic heart murmurs are common in health babies, kids, and teens. They usually go away during adulthood, but sometimes they remain. 

Causes

A physiologic heart murmur may be caused by:

  • Physical activity
  • Fever
  • Extreme anxiety
  • Anemia
  • Phases of rapid growth, such as adolescence
  • Hyperthyroidism
  • Pregnancy

Abnormal heart murmurs 

Abnormal heart murmurs usually indicate a heart condition or structural problem with one of the heart valves.

Causes

An abnormal heart murmur may be caused by:

  • Valve stenosis: a valve that’s tight, narrow, or stiff and doesn’t allow enough blood through
  • Valve regurgitation: a “leaky” valve that doesn’t completely close
  • Hypertrophic cardiomyopathy: a genetic condition that leads to a thick heart muscle wall, which can cause turbulent blood flow
  • Aortic root aneurysm: a widening of the first part of your aorta
  • Septal defect: a hole in your heart
  • Endocarditis: an infection of the inner lining of your heart and/or heart valves
  • Rheumatic fever: the result of improperly treated strep throat, which can result in damage to your heart valves

What are the symptoms of a heart murmur? 

Most physiologic heart murmurs are discovered during routine checkups, when your doctor listens to your heart with a stethoscope. 

It’s unlikely you’ll have noticeable symptoms from the murmur itself. However, if there’s an underlying condition causing the murmur, such as hyperthyroidism or fever, you may have symptoms from that condition.

If you have an abnormal murmur, it may be a sign of an underlying heart condition. Symptoms that may indicate an abnormal murmur include:

  • Shortness of breath
  • Chest pain
  • Dizziness
  • Tachycardia (accelerated heart rate)
  • Persistent cough
  • Cyanosis (blue skin around your fingertips and lips)
  • Swelling in your legs or bloating in your abdomen

You may also experience weight gain and excessive sweating.

Risk factors for having a heart murmur

Heart murmurs and defects can be hereditary. Plus, certain medical conditions can increase your likelihood of having a heart murmur. These include:

  • Hypertension
  • Pulmonary hypertension
  • Rheumatoid arthritis
  • Carcinoid syndrome

Takeaway

Stress and anxiety can cause a heart murmur that’s considered a physiologic heart murmur. However, it’s more likely that a heart murmur would be caused by an underlying heart condition, anemia, or hyperthyroidism.