Health
What is a heart murmur?
It's the sound of turbulent blood flow in the heart, heard through a stethoscope, that signals something worth investigating further.
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Saint Bernard Heart Murmurs: What the Sound Actually Means
Quick answer
What is a heart murmur?
It's the sound of turbulent blood flow in the heart, heard through a stethoscope, that signals something worth investigating further.
In Saint Bernards, a murmur can point to anything from an innocent puppy finding that resolves on its own to an early sign of dilated cardiomyopathy or a congenital valve defect, and only imaging tells the two apart.
Owners who hear the word 'murmur' at a routine exam and leave without a clear next step often end up either overreacting out of fear or, just as often, under-reacting because the dog looked fine walking out of the clinic.
Important reminder
This guide is not medical advice. If your dog shows pain, sudden behavior change, or worsening symptoms, consult a licensed veterinarian.
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Check this first
When a heart murmur signals an emergency
A murmur by itself is almost never an emergency. What turns it into one is what accompanies it: sudden collapse or fainting episodes, gums that look pale, gray or bluish, breathing that is labored even at rest, or a belly that appears distended alongside rapid breathing. Any of those alongside a known or newly found murmur should go to a vet immediately.
A murmur discovered with no other symptoms, especially in a young puppy, is often followed up on a normal timeline rather than rushed. Some soft murmurs in puppies under six months are innocent and resolve as the heart finishes developing, which a vet can usually distinguish from a murmur that suggests a structural problem needing a specialist's imaging.
The age at which a murmur first appears matters as much as how it sounds. A new murmur in a middle-aged or senior Saint Bernard is more concerning by default than one that has been present and stable since puppyhood, simply because adult-onset murmurs are more often tied to progressive disease like early dilated cardiomyopathy or valve degeneration.
If any of these apply, call your vet or an emergency clinic now. The rest of this page is for the cases that are not an emergency.
What this problem looks like
A heart murmur is a physical exam finding, not a disease by itself, and in Saint Bernards it can trace back to several different underlying causes ranging from harmless to serious. The murmur's grade, its location on the chest, and the age at which it first appears all give a vet clues, but only imaging like an echocardiogram actually identifies the cause.
Common triggers
- Congenital valve or vessel malformations present since birth
- Age-related valve thickening or degeneration
- Chamber enlargement associated with dilated cardiomyopathy
- Innocent, self-resolving murmurs in young puppies
- Anemia or other non-cardiac causes of turbulent blood flow
Murmurs are a frequently reported exam finding in Saint Bernards, given how often the breed's underlying cardiac risks surface as valve or flow abnormalities long before any visible symptoms appear.
Why this happens
Breed factors
Saint Bernards carry documented risk for both congenital heart defects and acquired conditions like dilated cardiomyopathy, and both can produce audible murmurs. A congenitally narrowed valve forces blood through a smaller opening, creating turbulence, while an enlarging heart chamber in cardiomyopathy can stretch valve structures until they no longer seal properly.
Environment factors
Environmental factors rarely cause a murmur directly, but conditions like anemia, dehydration, or extreme exertion can temporarily make an existing murmur more noticeable or, in rare cases, create a flow murmur unrelated to structural heart disease.
What you can do at home (once it is not an emergency)
When to talk to your vet
Talk to your vet promptly about any newly discovered murmur in an adult or senior Saint Bernard, or a puppy murmur that hasn't resolved by six months. Fainting, pale or blue gums, labored breathing at rest, or a distended abdomen alongside a murmur are emergencies and need same-day care.
At home, alongside your vet's plan
- Ask your vet to note the exact grade and location of any murmur found, so future exams can track whether it has changed.
- Request a recheck exam within the timeframe your vet suggests rather than letting a murmur go unmonitored indefinitely.
- Keep a simple log of your dog's exercise tolerance and resting breathing rate to give context if a murmur is found later.
- If cost is a concern, ask your vet which diagnostic step (echocardiogram versus X-ray versus bloodwork) gives the most information first.
- Avoid introducing new intense exercise routines until a murmur has been evaluated, especially in an adult or senior dog.
Mistakes owners make after a murmur is found
A murmur finding is a starting point, and a few common responses to it work against the dog.
- Assuming a low grade murmur means low risk: grade describes how loud the sound is, not how serious the underlying cause is, and a soft murmur can still sit above a significant structural problem.
- Declining the recommended echocardiogram because the dog 'acts totally normal': many giant-breed cardiac conditions have no visible symptoms in early stages.
- Getting a murmur checked once and never rechecking it: murmurs and the conditions behind them can change over months, and a single normal echo doesn't guarantee it stays that way forever.
- Confusing an innocent puppy murmur with an adult-onset murmur: a soft murmur that shows up for the first time in a six-year-old dog is a very different situation than one present since eight weeks old.
- Skipping a second opinion or cardiology referral when a general practice vet is uncertain about a murmur's grade or character.
More Saint Bernard health & behavior issues
Heart Murmurs in other breeds
- Cavalier King Charles Spaniel Heart Murmurs: Signs
- Cocker Spaniel Heart Murmurs: Signs, Lifespan & Treatment
- Dachshund Heart Murmurs: Signs, Lifespan & Treatment
- English Bulldog Heart Murmurs: Signs, Lifespan & Treatment
- English Cocker Spaniel Heart Murmurs: Signs & Treatment
- German Shepherd Heart Murmurs: Signs, Lifespan & Treatment
- Great Dane Heart Murmurs: Signs, Lifespan & Treatment
- Havanese Heart Murmurs: Signs, Lifespan & Treatment
- Jack Russell Terrier Heart Murmurs: Signs & Treatment
- Labradoodle Heart Murmurs: Signs, Lifespan & Treatment
See all Saint Bernard health problems, which breeds are prone to heart murmurs, or the full Saint Bernard breed guide for temperament, exercise needs and ownership costs.
What to expect, and how you know it is working
A murmur can be evaluated with imaging within days to weeks of being found, and the underlying condition it points to, if any, then dictates a much longer management timeline, often months to years of ongoing monitoring.
Success looks like having a clear answer for what the murmur represents, whether that's 'nothing structural, recheck in a year' or a specific diagnosis with a treatment plan already underway, rather than living with an unexplained finding indefinitely.
Priya and Duke: The Murmur That Turned Out to Be Nothing, and the One That Wasn't
Priya's Saint Bernard puppy, Duke, had a soft murmur noted at his first puppy visit. Her vet flagged it as possibly innocent and rechecked it at four and six months; it had disappeared by the second recheck, exactly as expected for that kind of finding. Four years later, at Duke's annual senior screening, a new murmur appeared that hadn't been there the year before. This time an echocardiogram showed early valve changes consistent with developing cardiomyopathy, caught well before Duke showed any symptoms at home.
Key takeaway: The same word, murmur, meant two completely different things at two different ages, and treating each one on its own timeline, rather than assuming the first experience predicted the second, is what let Duke's second finding get caught early.
Frequently asked questions
What does a heart murmur grade mean?
Vets grade murmurs from I to VI based on loudness, with I being barely audible and VI audible without a stethoscope even touching the chest. Grade describes intensity, not severity of the underlying cause, so a low grade murmur still needs evaluation if it's new or unexplained.
Is a puppy heart murmur in a Saint Bernard normal?
Some soft murmurs in puppies are innocent, related to normal heart development, and often resolve by six months of age. A vet can usually tell the difference between this and a murmur pointing to a structural defect, but any murmur in a giant-breed puppy is worth a follow-up recheck.
What tests confirm what's causing a murmur?
An echocardiogram is the standard tool, showing the heart's chambers, valves and blood flow directly. A vet may also recommend chest X-rays or an EKG depending on what the murmur's character suggests.
Can a murmur come and go?
The murmur itself is usually consistent if the underlying cause is stable, but murmurs can appear, change grade, or become more prominent as an underlying condition like valve disease or cardiomyopathy progresses over time.
What conditions cause murmurs in Saint Bernards?
Congenital defects like subvalvular aortic stenosis, acquired valve degeneration, and the turbulence associated with an enlarging heart chamber in dilated cardiomyopathy are all documented causes of murmurs in this breed.
Does every murmur need a cardiologist?
Not necessarily, but any murmur that is new, loud, or found alongside symptoms like reduced stamina or coughing usually warrants at least a discussion with a veterinary cardiologist about whether imaging is needed.
How much does a cardiology workup for a murmur cost?
An echocardiogram with a cardiologist consult typically runs several hundred dollars, and the cost can increase if additional imaging or monitoring like a Holter recording is recommended.
Quick answers
View more answersHealth
Should I worry about a low grade murmur?
Grade reflects loudness, not danger, so a soft new murmur still deserves a vet's evaluation rather than being dismissed.
Living
Can a murmur mean nothing at all?
Yes, some puppy murmurs are innocent and resolve on their own, but this should be confirmed by a vet rather than assumed.
Health
What's the next step after a murmur is found?
Most vets recommend an echocardiogram to see exactly what is happening at the heart and valve level.
Costs
Is checking a murmur expensive?
A cardiology consult with imaging is a real cost, typically several hundred dollars, but it's the only way to know what the murmur means.
Related DogBreedCompass guides
- Saint Bernard heart conditions overview – A murmur is often the entry point into a broader cardiac workup.
- dilated cardiomyopathy in Saint Bernards – Dilated cardiomyopathy is one of the most common causes of a new adult-onset murmur.
- congenital heart defects in Saint Bernards – Subvalvular aortic stenosis is a congenital cause of murmurs specific to giant breeds.
- Saint Bernard veterinary cost planning – Owners often want to know what routine cardiac screening costs overall.
- ventricular arrhythmias in Saint Bernards – Irregular heartbeats sometimes accompany a murmur finding.
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