Ask Me Anything #3: “How Bad Does My Heart Murmur Have To Be Before It Gets Fixed?” Asks Ruth

In our third “Ask Me Anything” video from the Mitral Conclave, Dr. Patrick McCarthy, the chief of cardiac surgery at Northwestern Medicine, answers Ruth’s question, “How bad does my mitral valve heart murmur have to be before it gets fixed?”


Many thanks to Ruth for her question and a special thanks to Dr. McCarthy for sharing his clinical experience and research with our community!

Keep on tickin!

P.S. For the hearing impaired members of our community, I have provided a written transcript of this video with Dr. McCarthy below.

Adam: Hi, everybody! It’s Adam and we’re at the Mitral Conclave in New York City. We’re answering your questions that were submitted at I am very excited to be here with Dr. Patrick McCarthy, who heads the Bluhm Cardiovascular Institute at Northwestern Medicine in Chicago.

A question, Dr. McCarthy, comes in from Ruth, and she asks, “How bad does a mitral valve heart murmur have to be before I need to get it fixed?”

Dr. Patrick McCarthyDr. Patrick McCarthy

Dr. Patrick McCarthy: It’s a good question, Ruth. Actually we hear that one a lot and the answer is probably surprising in that how loud the murmur is doesn’t really mean that much to us. It’s just the murmur itself is a thing that gets us started to check it out and to follow it. Imagine you’re driving your car and you hear this clunking noise; that’s sort of the murmur. It’s not like if the clunk is really loud then things are worse. You may have a quiet noise that may be really bad.

Let me give you some examples. Aortic stenosis, which is very common, probably the most common heart valve can be very loud murmurs, and on those we usually operate. Aortic regurgitation, where the value leaks, are very quiet, and so those maybe really important clinical problem but the murmur is so quiet, it may go undetected for a long time. When you finally show up with the murmur indicates that you need to have an echo.

The murmur itself, how loud it is, tells us various things about the valves. Really when you get a full evaluation with an echocardiogram is when we start to make decisions. It’s a very good and a very common question.

Adam: Your recommendation, Dr. McCarthy, for someone like Ruth would be to get a regular echocardiogram.

Dr. Patrick McCarthy: Well first is when people have a new murmur. People have lived all their life, nobody found it but then suddenly a new doctor, or a doctor that they’ve seen says they have a heart murmur, it’s time to get an echocardiogram. You want to look at those heart valves. You want to see what’s wrong.

If it’s a patient that they have been following for many years, perhaps with a cardiologist, some people are going every three months, some every twelve months, may not need an echo every three months, of course. Then if they’ve been listening to it and it sounds exactly the same and they know what it is, they may just say, “We’re okay.” If it is getting to be every twelve months, or if it sounds a lot louder, things are changing and then they’ll get an echo.

Adam: Great. Well, Ruth, I hope that helped you. Dr. McCarthy, I just want to thank you for your extraordinary support of our community. All the patients who have come to you, on behalf of them, all the people watching this, I just want to say thank you for all your help at Northwestern.

Dr. Patrick McCarthy: Thanks, Adam. Thank you for all that you do for the patients.

Adam Pick
Written by Adam Pick

Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of

To learn how Adam has helped millions of people with heart valve disease, watch Adam's video, subscribe to his free newsletter, or visit his Facebook, or Twitter pages.

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