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What You Need to Know About Heart Murmurs and Running

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Runners’ hearts are different. After years and decades of frolicking around in our running shoes, our hearts may be bigger and have bigger atria, more flexible coronary arteries and more abundant coronary capillaries than those of our couch potato counterparts. And while these adaptations all seem positive, the media often has a field day about the potential negative links between running and heart health.

One such grey area, is the topic of heart murmurs and running. Many runners are unclear on the matter and have a myriad of unanswered questions. Like, for example, if running can be a possible cause of heart murmurs? And if one can safely keep on running after being diagnosed with a heart murmur? Have you been unclear on this too? Here’s what you need to know.

What Is a Heart Murmur?

Before we look at the potential implications of running with a heart murmur, let’s just take a step back and properly define what a heart murmur is. In short, a heart murmur is basically the sound made by turbulent blood flow within the heart. This turbulence is often caused by a change in blood flow through one of the heart valves and can be picked up by a physician with a stethoscope during a physical exam.

What Causes Heart Murmurs?

So what exactly causes this change in blood flow through the heart valves? And is it always indicative of a serious problem within the heart? Fortunately not. Heart murmurs can occur in both sick and normal hearts. And in fact, turbulence is often a normal occurrence in a normal heart, referred to as a benign flow murmur.

Innocent or Benign Flow Heart Murmurs

In the latter instance, a change in blood flow can be caused by anxiety, fever, severe anemia or something as simple as an increased heart rate after exercise. Approximately 10% of adults and 30% of children experience innocent murmurs produced by healthy, normal hearts at some stage of their lives.

Innocent heart murmurs do not present any palpable symptoms and therefore often go unnoticed.

Serious Heart Murmurs

On the flip side of the coin, however, a heart murmur may also be a symptom of a problem within the heart. This problem can either be structural, where there is a structural abnormality in one of the heart valves or chambers, or it may result from an abnormal connection between two parts of the heart. Some of the abnormalities that can lead to murmurs include:

  • A heart valve that is either tight or leaky.
  • Mitral valve prolapse, or the leaking of blood back from the left ventricle to the left atrium.
  • Congenital heart issues, in other words heart issues that were present from birth, including septal defects or patent ductus arteriosus. The former condition involves abnormal openings (or holes) in the septum of the heart. The latter condition occurs when the ductus arteriosus doesn’t close once a baby is born and able to breathe through his or her own lungs.
  • Endocarditis, or inflammation of the heart valves and lining of the heart chambers.
  • Cardiac myxoma, or a benign tumor growing within the heart, which partially obstructs blood flow.
  • Asymmetric septal hypertrophy, or abnormal thickening of the heart muscle in the left ventricle.

And while innocent heart murmurs present no symptoms, serious heart murmurs may present a variety of symptoms. These manifestations depend on the murmur’s origin and may include the following:

  • Dizziness
  • Shortness of breath
  • Intervals of rapid heartbeat
  • A decreased tolerance for physical exertion
  • Chest pressure or pain

It is therefore vital to seek professional medical attention if and when experiencing one or more of these symptoms. A suitably qualified physician will most likely perform a number of tests, where after a proper diagnosis will be made.

Can I Run with a Heart Murmur?

And while having a heart murmur may sound like the end of your running career, this is fortunately not always the case. It is, however, vital to firstly get a proper diagnosis by a suitably qualified physician, and secondly get to the root of what is causing the murmur. Once these facts are on the table, your cardiologist will be able to give you a proper set of guidelines for physical activity going forward.

Remember, though, that even if your cardiologist does give you the green light for continuing running, it is vital to remember to stop activity and seek medical attention immediately when experiencing any of the following:

  • Chest pain
  • Changes in breathing
  • Undue fatigue

Will a Heart Murmur Impact Running Performance?

And what about running performance, you might ask? If you’ve been diagnosed with an innocent heart murmur, and your cardiologist has given you the go-ahead to continue running, will the condition negatively impact your running performance? Not according to sports medicine doctor Cathy Fieseler. If, after proper assessment of your heart valves and muscles, you’re given the green light to continue competing, then “… your heart valves and muscle should be functioning normally and the murmur should have no impact on athletic performance,” says Fieseler.

Listen to Your Cardiologist and Your Body

So while a heart murmur will not necessarily mean the end of your running career, it’s important to first and foremost have it checked out by a physician. And if you do get the go-ahead to keep on running despite having a murmur, always do so within the limits set by your cardiologist. Also check in with your doctor regularly and always run under his or her close guidance.

And if, on any given day, you experience warning symptoms despite sticking to the guidelines, stop immediately and have it checked out. Better safe than sorry!


  1. William O. Roberts, MD, Marathoning and heart murmurs, Online publication
  2. Cathy Fieseler, Ask the coaches: Heart murmur, Online publication
  3. Harvard Health Staff, Heart murmur, Online publication
  4. Alex Hutchinson, How runners' hearts are different, Online publication

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