December 30, 2020

Can You Play Sports With a Heart Murmur?

Information you need, on and off the field

athlete undergoing testing on heart

You’re preparing for your sports physical, and your doctor comes at you with a cold stethoscope, ready to listen to your heart. But what does your heart have to say? Potentially, a lot, according to cardiologists Tamanna Singh, MD, and Michael Emery, MD.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Made up of four chambers and four valves, one of your heart’s most important jobs is to keep blood flowing in one direction. The valves work like one-way swinging doors that let your blood move to the next chamber or to the major arteries of your body, but never backward.

When your doctor listens to your heart, a “lub-dub” sound can be heard when your heart valves close. But sometimes, a “whoosh” or “swish” sound also can be heard due to turbulent blood flow near your heart. That’s a heart murmur.

Do you need to be concerned?

In athletes, most murmurs are called physiological, or “innocent” murmurs. They can be a sign of increased cardiovascular fitness rather than a harmful heart abnormality.

“In response to consistent, high levels of endurance activity, your heart may adapt by becoming slightly enlarged, which allows it to move greater amounts of blood with each contraction,” says Dr. Singh. “That amount, called the stroke volume, is sometimes heard on physical exam when your doctor places a stethoscope to your chest,” she says. This finding is more prominent in young athletes and aerobic endurance athletes.

However, that swishing sound can also be related to a problem with the heart.

The murmur may represent turbulent blood flow related to narrowing or leaking of one or more of the heart valves — or, rarely, a small hole in the heart. Dr. Emery says it could also be due to a condition called hypertrophic cardiomyopathy, which can cause abnormal thickening of your heart muscle. This can block or reduce the blood flow from the left ventricle of your heart to the aorta (the body’s main blood vessel).

Advertisement

“So, if your doctor hears a heart murmur, it’s important to determine the cause for this sound,” says Dr. Emery. Is it innocent? Or is it caused by abnormal pathology? He says on a rare occasion, a murmur may be a sign of a greater problem that would place an athlete at risk of sudden cardiac death or other health issues.

Your doctor should be able to tell the difference between a physiological murmur (considered a normal and benign finding) and pathological murmur (cause for follow-up), based on the timing and pitch of the murmur.

But if there’s still any question of how significant the murmur is, then your doctor will likely order an echocardiogram. This is an ultrasound of your heart, and it’s performed by placing a special wand on your chest that uses sound waves to create a computerized picture of your heart as it beats.

An echocardiogram also shows the size of your heart’s chambers, how well your heart is pumping, and how efficiently the valves are opening and snapping shut.

A sports cardiologist can help

If you do have a pathological heart murmur, your doctor will let you know if you need treatment (not all require treatment), and how the condition may or may not affect your day-to-day activities, including sports participation.

“In most cases, people with murmurs have no symptoms,” says Dr. Singh. But the most common symptoms athletes report include shortness of breath or chest pain with activity and a decrease in exercise capacity. Others can experience lightheadedness and fainting episodes.

Advertisement

These symptoms occur because the forward flow of blood is limited, and without adequate nutrient-rich blood flow reaching the active muscles and organs, performance declines.

However, it’s also important to know that heart murmurs can, in some rare instances, exclude you from sports participation. If you have an underlying heart condition, vigorous exercise can increase the stress placed on your heart, and in some cases may lead to arrhythmias or a more rapid deterioration in heart function.

On rare occasions, if a detected heart abnormality carries a significant risk of long-term damage to your heart or sudden cardiac death, you may need to stay off the field for your health.

Your heart may be trying to tell you something — and your sports cardiologist can tell you what it is.

Related Articles

Cholesterol blocking blood flow in artery
February 26, 2024
What It Means if You Have ‘Sticky’ Cholesterol

LDL cholesterol and lipoprotein (a) cholesterol are more likely to stick to your arteries and lead to dangerous heart events

Doctor shaking hands with patient, with large heart and EKG line behind them
February 19, 2024
How Weight Affects Your Heart

Having underweight, having overweight and having obesity can be dangerous for your heart

Close up of hands holding heart rate wearable watch monitor and their phone
February 12, 2024
Next Time You Exercise, Consider Wearing a Heart Rate Monitor

This technology can benefit your workouts by helping you hit your target heart rate, resulting in better overall health and wellness

seated doctor and female in doctor office, with female's hand on heart, with daughter
February 8, 2024
Here’s When You Should Go to the Hospital for a Dangerous Heart Rate

A resting heart rate below 35–40 beats per minute or over 100 beats per minute may be cause for concern

healthcare provider speaking with older female in office
February 6, 2024
How Estrogen Supports Heart Health

Your natural estrogen levels support a healthy heart by improving your cholesterol, increasing blood flow and reducing free radicals

Flaxseed sprinkled on a salad in a white bowl on a dark wooden table
January 31, 2024
Flaxseed: A Little Seed With Big Health Benefits

Ground flaxseed is full of heart-healthy omega-3s, antioxidants and fiber, and easy to add to just about any recipe

Older male in doctor's office with doctor holding tablet showing heart statistics
January 31, 2024
Extra Heartbeats: Should You Be Worried?

They’re rarely cause for concern, but you should still talk to a healthcare provider about your symptoms

Older male in helmet biking on forest trails
January 17, 2024
What Does ‘Moderate-Intensity Exercise’ Mean Anyway?

From gardening to walking for 30 or more minutes, you want to get your heart rate up 50% to 60%

Trending Topics

close up of keto gummies
Do Keto Gummies Work for Weight Loss? Are They Safe?

Research is inconclusive whether or not these supplements are helpful

Person in yellow tshirt and blue jeans relaxing on green couch in living room reading texts on their phone.
Here’s How Many Calories You Naturally Burn in a Day

Your metabolism may torch 1,300 to 2,000 calories daily with no activity

Older person postioned sideways showing dowager hump.
Dowager’s Hump: What It Is and How To Get Rid of It

The hump at the base of your neck may be caused by osteoporosis or poor posture

Ad