Heart Murmurs

[Dozza2k]

Hey,
Yes i have one. The doctor doing that part of my class 1 on friday said he saw about 5 a week and they were quite common. I am still full of hope as my chest x ray was clear, and my cholestorol is excellent, and my heartbeat was fine. He said it was either a problem with my heart and thus i could'nt get a C1, or it was a 'natural murmur'. Does anyone know what one these means with regard to a flying career? Do any of you have one? Any comments would be appreciated, thanks in advance.
Dozza:cool:

[slim_slag]

If you are an otherwise fit and healthy youngster, there is a very high probability it's one of these "natural murmur" things and you will survive to old age, then die of something else. What's the doc going to do next? Sounds like (s)he is the best person to listen to.

[Dozza2k]

i am a healthy and fit youngster, i think :O . The doc is making me have an ultrasound of my heart to see if anything comes up, and IF that is clear, my dreams are back on track!

[robwilson]

Same thing happened to me, 2 week wait, ultra sound, comment from cardioligist "bloody hell your hearts loud" sent report to CAA, "thats fine". Dont worry.

[GARDENER]

Had exactly the same experience as above.......only difference was after the ultrasound I then had to return to Gatwick with a further £100 and speak to the top dog for five minutes only to be told he could not hear anything untoward. Sure you will be fine!

[slim_slag]

Just an observation but I find it of interest and others may too.

In the UK, if you go to see a doctor for a sore throat and he finds a "natural murmur" you are probably not going to get any fancy heart tests. If you go to see a doctor for a class 1 medical and he finds a "natural murmur" he will ask for all sorts of expensive tests and you may be denied a medical for reasons that have nothing to do with your safety as a pilot.

In the US, if you go to see a doctor for a sore throat and he finds a "natural murmur" you could easily be subjected to a lot of expensive tests. If you go to see a doctor for a class 1 medical and he finds a "natural murmur" he will probably ignore it and send you away with the class 1 medical you asked for.

Maybe a generalisation, but I find the different approach in the two countries to a patient who is also a pilot quite interesting.

[Sick Squid]

I don't mind owning up to being the owner of one of these... a "soft systolic murmur" which I was very interested to see on inspecting my medical notes once was mentioned on Day One of my life by the doctor who slapped me (the first of many slaps, I have to add, and still they come :sad: ) and brought me onto the planet.

Have had the Echocardiogram-thingy a few years back for an employment interview, and everyone came away happy. It does make medical renewals interesting as if it is a new Doctor I always like to see the CRM manner in which they first find it, then question me about it.. suppose I could tell them, but find it interesting to see the different approaches.

Was simply explained to me as a little insignificant turbulence around a valve... everything else, cholesterol, BP, is excessively normal (at the moment, fingers crossed) so don't know if that would ever tilt the tables slightly... thats where a bit of medical opinion is required, not just the poorly-informed comments of a clueless owner like me! :D

Squid

[Hawk]

Aww poor Squiddy. Now you come and have a lie down at Min and Hawk's Moderators' Sick Bay and give that little heart a rest. We have a bottle of medicinal mango wine especially for such occasions.

[Inverted81]

Hi Fred,
I'm not a doctor, so this only things as i see it ;)
First of all i wouldn't panic... if you haven't shown any other symptoms then you should be fine and dandy. I was diagnosed as having one as a baby then before my RAF medical 4 years ago for a scholarship, it was all cleared. I recently went for my initial class 1 as well and was told that i have the murmur again (if it ever did go away that is). I feel fine, my ecg and chest x ray are all clear, so i am not worrying. I have read around the subject a bit more and my understanding is that heart murmurs are a VERY COMMON problem, and often are never detected. it just indicates a leaky valve or turbulent flow etc... my doc also said it could also just be caused by anxiety. I'm being sent for an echocardiogram as well, as the CAA will need proof that the murmur has been investigated ( i believe just a matter of procedure etc) and i was implicently told NOT TO WORRY. Now obviously every case is different, but the chances are, everything will be A OK. I just wanna get my test sorted and done with as well... :\ hee hee.
take it easy.... no need to panic....
Chris

[Inverted81]

Hi, mines getting paid for through NATS as i'm hopefully going to be starting my ATCO course in the new year, i've heard many rumours about price. Unfortunately i dont think its very cheap at all. i dont know if this is true or not but i've heard prices in the range of £400-800!!! :ugh: perhaps someone can clarify this both for NHS and private????
I just hope to hear the words "ur ok!" lol.

C

[santan17]

I have a heart murmur which they discovered on my third renewal, so the doc grounded me and sent me to Gatwick, the specialist there might have been bored or something but the way he was talking and frowning , I thought I only had days to live, stuff like "when we get your results back we are going to have to sit down and have a serious talk about your future..." (Im only 22) Anyway to cut a long story short I got the test results, asked to see a different doctor and he said I was fine come back in 2007 for another echocardiogramme...
I also got another heart specialist to check it out just in case I was about to expire or something but he said he could hardly hear it at all, so what that guy at the CAA was smoking I dont know. Not nice though.


Santan

[Bendo]

G'day Lads,

I was diagnosed with a murmur as a kid and it was properly investigated when I was 17 - it scratched me from RAAF pilot selection.

However, it hasn't precluded me from working as a commercial pilot for the last 10 years. I am now 30 and I run half-marathons and play rugby, chase the wife around etc etc etc.

My murmur is caused by having a bicuspid (two-leaf) aortic valve instead of a three-leaf valve like 97% of the population.

When having a regular check-up last Dec the cardiologist found that my aorta was dilating, stretching out to a diameter of 54mm. The normal dia. is 25-30mm.

I was booked in for corrective surgery; I flew until the day before the Operation and my medical certificate will be re-issued 10 weeks post-operatively with no restrictions.

The surgeons removed the dodgy aorta and installed a nice little white dacron hose in its place; I might need a valve replacement in 15-20 years, I might not.

IN SUMMARY,

It might seem bad but it ain't; if investigations show something that needs to be monitored, make sure you keep it monitored regardless of the cost.

If I hadn't had this checked I could have ruptured at any time and had a short, agonising death... which would NOT have been good in an aeroplane.

Stay well.

[London Girl]

I went through exactly the same process back in May when I was told at my initial Class 1 that I had a heart murmur. My heart was also slightly enlarged but was still within normal limits. I was told that I would have to have an echocardiogram. I was slightly worked up and worried that my pilot ambitions were out of the window, so booked the echo 3 days later - I went private and it cost £320 (ouch!) but was told NHS could take up to 10 months so it seemed the better option.

Anyway, after 20 minutes of scanning the specialist sent a fax to the CAA saying all was fine and I had a natural murmur. I received my Class 1 the following week. The specialist told me he sees hundreds of people referred by the CAA - at the end of the day, they have to be sure we are fit and healthy before issuing the Class 1 and don't take any chances!

I really wouldn't worry - in 99% of all referrals there is nothing wrong at all..

This was my post back in May, which eased my concerns! http://www.pprune.com/forums/showthread.php?s=&threadid=131524

Good Luck!

[atse]

Yes, that's it. The important thing is that a "murmur" is just like a ?

And once somebody (who has to get paid) says that the ? is really nothing, then your problems are over.

And 99% of the time the ? is really nothing.

None of which helps when you get told there is a ? and you get the **** scared out of you.

[Inverted81]

Hi,
Had my echo tonite, and am glad to say all is 100% fine. Its only a feint "flow" murmur so will never need any follow up checks etc. Thanks for all the info guys, and for those of you readin this because you're worried there really isn't any need to be.... just get it checked out and more than likely ya should be fine! ATCO training here i come! lol
C

[Rabid Dog]

For a living, I listen to hearts several times a day. With regards to murmurs, one of things happen:
(a) I can't hear one, someone else can -> intellectual argument as to the significance of the murmur;
(b) I can hear one, no-one else can -> intellectual argument as to the significance of the murmur;
(c) A murmur is there, it's been hear (and documented) as being heard before, ignore it;
(d) A murmur is there, it's not been heard before -> intellectual argument as to the signifcance of the murmur;
(e) etc.
As you can see, a murmur in the general population is generally ignored, unless there is a suggestion that it is related to an infection etc. involving the heart ( and these are pretty rare). I think why the murmurs are so investigated is two-fold - there is a tradition in medicine to 'do' something aboutit; and if you're ever unlucky enough to be involved in an incident, people are covering their backs in advance.
In essence - don't worry too much, their usually medically benign, and although stressful from the point of view of licence renewal, generally of no consequence.

[Speed Twelve]

Glad to hear your ticker checked out OK.

When I went through pilot selection with the RAF I was diagnosed as having a 'slight murmur' which had no corroborating symptoms. I was otherwise fit, and the docs put it to me that if it was significant I would have probably have dropped dead on the squash court by then anyway.

Was sent to the RAF's Central Medical Establishment in London to see an Air Commodore specialist who gave me an echo-scan, during which he announced that I was firing on all cylinders and did in fact just have a 'noisy heart' due to it being rotated slightly on its axis compared to other people. No snags thereafter.

Incidentally the above visit to CME occurred after I had been provisionally accepted for pilot training conditional on medical fitness. If I had not passed selection I would have walked away still wondering whether or not I was about to drop dead!

On many subsequent civilian Class 1 medical renewals no evidence of a murmur has been found.

ST

[YVRKid]

What exactly is a heart murmur:confused:

[slim_slag]

Mooney,

Isn't that lup dup ??? ;)

YVRKid,

Heart without murmur goes 'lup dup, lup dup' (or whatever)

Sometimes you hear

lup shhhh dup, lup shhhh dup

The 'shhhh' is the murmur, this could be considered to be turbulent blood i.e non laminar which causes a noise. Blood might be turbulent because of a rough spot on a valve, or more usually in young adults because their heart is just doing a good job.

Then sometimes you hear

lup dup sh, lup dup sh

The sh is in a different place, geddit????

And then you scratch your head and wonder what is the meaning of life and funny noises emanating from the heart.

Ah, google is such a wonderful tool

DIY Cardiologist (http://home.cwru.edu/~dck3/heart/listen.html)

If the truth be known, the art of listening to the heart is dying fast. I forget the figure, but lets say 30% of American physicians couldn't recognise a systolic from a diastolic murmur, the stethescope around the neck is a status symbol more than anything else. It's just easier to echo somebody and get the real answer, and this also generates further revenue from the medical insurance company.

[Bus429]

I spent two days earlier this month walking around with a 48-hour monitor on my belt and mini Jodrell Banks on my chest.
I get irregular beats every day and occasionally need to cough to halt a prolonged bout (it's true!).

Still waiting for results - ECG tests are always fine and the heart never "plays up" when I'm hooked up!

[alapt]

Well today the axe has fallen for me. After 20 years of medicals, they foung something on the ECG. So I have lost the FAA and Canadian licenses.
Seems like I have a skipping beat that has to be investigated further. So I did the ultra sound, another ECG and a stress test. everything was or is fine. Then they attached a machine with probes that recorded everything for 24 hours. Due the the results of this, they could not issue another medical. Now the file has been sent to OKA and they will advise........great!
The docs said that I might need a pill called a "beta blocker"!
If there are any docs here, or if any one had simmilar experiences, please inform me ....

[Colonel W E Kurtz]

Help! The Doc said I have a murmur and have to go for an ultrasound!! I'll let you know how it goes, i've never had anything diagnosed before so this is a worry.

[Thomas coupling]

alapt: beta blockers attempt to regulate the flow of adrenaline which may affect your heart's rhythmn. You cannot fly single pilot a/c with this medication, but you should be fine for multi crew. Which aviation authority are you under?

Get a second opinion: ALWAYS!



:ok:

[alapt]

Thanx TC. I recieved the exact terms from the Doc.
In french it is "extrasytoles Ventricular"...Ventricular systales I think with "supra Vebtricular" what ever that is?
Seems like If I stop smokind and drinking.....and excercise things should get better........
Maybe this is the calling for me, better late than never or too late I guess. Thanx again for the info and hope you have more?

[Thomas coupling]

Alapt: IF it is 'extra' heart beats or PAC's as they are sometimes referred to, it depends on how often they occur. If the frequency of these beats exceeds the guidelines laid down by the air medical dept in your CAA, then they err on the side of caution and pull your ticket!
This prognosis however is open to interpretation in that the physiology of the individual can be the predisposing cause of the irregular beats.
For instance, it is either the start of some heart defect, or....much more likely triggered by:
adrenaline (excess) caused by anxiety/stress/fear/fright etc.
Cafeine (tea, coffee, coke, red bull!)
Wine (particularly red).
Alcohol
Nicotine.

These triggers cause the beat to misalign in certain individuals (it is estimated that at least 20% of the UK population suffers from this type of irregular beat. It is completely benign in its basic form and only becomes a cause for concern when it transforms into other arhythmias.

Problem is not helped when you go to the aviation doctor, because of the anxiety from worrying what they will find, it exacerbates the situation furhter!!! White coat syndrome!

Exercise definitely helps, cut out coffee cut back the alcohol, no wine, no work in case of stress....then you'll be fine:uhoh:

[likair]

Hello ppl,

A few days ago I went to do my last medical test for my 2nd Class Med. Cert. It was very dreadful before entering every particular test, especially the eyesight. But it was all ok except for the ECG. The one that expected to lack performance went quite good (eysight) and the one which i really took forgranted was the one which worried me most!! That's life :\

After the doctor attached me the patches and saw the graphical results from the machine I saw his strange expression on his face. My heart really made a tick!!

He told me that he's going to check further with a stethoscope. After changing varies positions on my chest with his diaphram he told me you have a heart murmer :sad: My heart was also slightly enlarged. I was told that I would have to have an echocardiogram. I am slightly worried that my pilot ambitions are out of the window, so booked the echo for the next 2 weeks.

P.S. The graph showed a steep "hill" which normally at my age (21) must be quite small. This showed that probably I have a heart murmer.

Do I have to worry a lot about it? Is it normal? Can this limit me to gain Class 2 or further on the Class 1 Medical Cert.
Any comments?
Preoccupied

L|kA|r:confused:

[slim_slag]

so your doc sticks the ECG wires on your chest before he listens with his stethescope? What's the world coming to. 21 yrs old and otherwise healthy, don't worry about it.

[likair]

Hello again,

Yes thats right Slim_Slag,

the doctor attached the ECG patches on my chest before listening with with his stetheopscope. Why? Is that not the procedure??? :confused:

I will let you know regarding the result of the echo.

Regards
L|kA|r :ok:

[Inverted81]

Hi,
i know how you are feeling. i went thro the same process a couple of months back (see earlier posts). i now have a class one ATCO medical (UK) and all seems fine. Try not to get to tensed up about the whole thing. The Echocardiogram should sort out exactly what causes the murmur, ask as many questions as you can , the more info you have the better!!!

Good luck!
let us know what happens
Chris

[likair]

Hello Chrisf

Thanks for your courage, sure I will let you all know about the echocardiogram!!

Cheers and take care!!

:ok:

L|kA|r

[slim_slag]

likair, these fancy machines that go 'ping' are supposed to be used to confirm a diagosis made using clinical skills and a physical exam with the stethoscope (after you have inspected, palpated and percussed :)). Admittedly, the ECG is mainly a screening tool in these medicals, and probably not a good one at that, but they are cheap and available and do catch some things so I guess why not use them. You will also get a baseline ECG which might be useful some years down the line, except you will not have it when it's needed :)

Getting a stethoscope out to confirm a diagnosis of a heart murmur made by a ECG machine (or the computer within having some fun) is a bit bizzare in my book.

The echo will tell you exactly how large your heart is, and whether there is anything wrong with the murmur. Just another test you have to pay for unfortunately.

[likair]

Hello Slim_Slag

That's right !!

Hope that with the echo test all the doubts are discarded! Yepp unfortunately I have to pay another test which is quite more expensive compared with the other ones!!:ugh:

But I prefer to pay and know what I have and learn about my health :O
Hope for the best :ok:

Regards
L|kA|r

[likair]

Just returned from my echo tests.

All the murmur doubts from the ECG test machine are all discarded. Now the doctor has assured me that my heart is regular and functioning very well with the Echo test. :ok:

The reason that a suspect of a murmur was because of a high peak wave form from the ECG test. He told me since I have a athletic body (slim) ie less resistance for the ECG machine to scan heart pulses therefore it resulted suspects.

Thanks for your attention and your help!!

L|kA|r

:O

[slim_slag]

Glad to hear you are fine likair. Has anybody who has asked about echos on this forum ever had a "real" problem?

[Kowboy]

It doesnt always work out, after many years as a private pilot and a 1000 or so hours, I went to have my medical and found that I also had a murmer.

After some tests, they discovered the above, and pulled my ticket.

Cant do jack now.

[gingernut]

I thought the stethoscope was to impress the chicks.

What is this "clinical examination" thing everyones on about.

[FaPoGai]

Dozza2k
See all below. If you come up against the wall try to see Prof.Douglas Chamberlin at the Brighton Heart Support Trust.
Tel. 01273 664945. He is the CAA cardiac consultant, but is on your side. And dont be put off by the cost of the angiograms they are worth it and will probably keep you in a job and save your life.

BENDO
Thanks for a really positive post. My experience mirrors your own. Except that I got through my whole career without interruption and now at 67yrs. am expecting the valve replacement any day.
Posts such as yours are really of great value and many will benefit from it.
Best rgds. FPG

[slim_slag]

Yes, Douglas Chamberlain is the best and a great guy too, one of those who really works hard for his patients and the community at large. If you get him on your side you have won the medical argument.

[BusyB]

Prof Chamberlain is no longer based at Brighton and will be fully retired shortly. I think he is still available at LGW park. Dr S O'Nunain is very helpful at Brighton.