🎯 Bottom Line Up Front
Can you get life insurance with a heart murmur? Yes. Most people with heart murmurs qualify for coverage, with rates ranging widely based on murmur type and significance. Innocent (functional) heart murmurs typically receive standard or better rates with no underwriting impact, while pathological murmurs from valve disease may result in standard to table ratings depending on valve dysfunction severity, symptoms, and treatment requirements. The key distinction is whether your murmur is benign or reflects underlying structural heart disease.
This comprehensive guide examines how life insurance companies evaluate heart murmurs, what factors determine whether your murmur affects coverage, and strategies to secure the best possible rates based on your specific cardiac status.
Adults with Detectable Murmurs
Children with Innocent Murmurs
Adults with Significant Valve Disease
Murmur Intensity Scale
Table of Contents
- Understanding Heart Murmurs and Insurance
- How Insurance Companies Evaluate Heart Murmurs
- Coverage Outlook by Murmur Type
- Key Underwriting Factors
- Optimal Timing for Applications
- Required Medical Documentation
- Strategies to Improve Your Application
- Alternative Coverage Options
- Frequently Asked Questions
Understanding Heart Murmurs and Insurance
Key insight: The cause of the murmur matters infinitely more than the murmur itself.
A heart murmur is an extra or unusual sound heard during a heartbeat, typically described as a whooshing or swishing noise. Murmurs occur when blood flows turbulently through the heart or blood vessels. The vast majority of heart murmurs are innocent (also called functional or physiologic), meaning they occur in structurally normal hearts without disease. These innocent murmurs commonly arise from increased blood flow during pregnancy, fever, anemia, or exercise, and are particularly common in children. Pathological murmurs, in contrast, result from structural abnormalities like valve stenosis (narrowing), regurgitation (leakage), septal defects, or other congenital or acquired heart conditions.
For life insurance purposes, heart murmurs themselves pose no direct mortality risk—the sound is merely a physical finding detected on examination. What matters entirely to underwriters is whether the murmur reflects underlying cardiac pathology that does affect prognosis and life expectancy.
Innocent murmurs documented by echocardiography showing normal heart structure and function receive no underwriting penalties whatsoever, as they represent benign variants that don’t require treatment or monitoring. Pathological murmurs undergo evaluation based on the specific valve lesion or cardiac abnormality present, with underwriting focusing on valve dysfunction severity measured by gradient and regurgitation degree, presence of symptoms like dyspnea or chest pain, left ventricular function and chamber dimensions, whether surgical or percutaneous intervention has occurred or is anticipated, and evidence of heart failure or other complications. A Grade 2 innocent murmur in a 30-year-old with a normal echocardiogram receives standard or preferred rates identical to someone without any murmur, while the same Grade 2 murmur from severe aortic stenosis with symptoms would face substantial table ratings or possible decline despite the identical auscultatory finding.
Professional Insight“We regularly secure preferred rates for clients with heart murmurs—innocent murmurs literally have zero impact on underwriting once documented as benign. Even many pathological murmurs receive standard rates if the underlying valve disease is mild and well-monitored. The key is providing complete echocardiographic documentation so underwriters can assess the actual cardiac status rather than worrying about an isolated physical examination finding. Never let a murmur diagnosis alone discourage you from applying.”
– InsuranceBrokers USA – Management Team
Types of Heart Murmurs
Life insurance underwriters categorize murmurs based on underlying cause and hemodynamic significance:
| Murmur Type | Characteristics | Typical Insurance Impact |
|---|---|---|
| Innocent/Functional Murmur | No structural abnormality, normal echo, often Grade 1-2, may disappear with position changes | No impact – Preferred to Standard rates |
| Mitral Valve Prolapse (MVP) | Very common, usually benign, mild regurgitation common, most asymptomatic | Standard to Table 2 depending on regurgitation severity |
| Mild Valve Regurgitation | Trace to mild leak, no chamber enlargement, asymptomatic, stable | Standard or better rates typically |
| Moderate Valve Disease | Moderate stenosis or regurgitation, may have chamber changes, symptoms possible | Standard to Table 4 depending on specifics |
| Severe Valve Disease | Severe stenosis or regurgitation, symptoms present, intervention likely needed | Table 4+ or postponement until treated |
| Post-Valve Surgery | Prosthetic or repaired valve, variable function and prognosis | Table 2 to Table 8+ depending on valve type and function |
How Insurance Companies Evaluate Heart Murmurs
Life insurance underwriters focus entirely on the cause and hemodynamic significance of heart murmurs rather than the murmur itself. The evaluation process determines whether structural heart disease exists and, if so, its severity and impact.
Primary Underwriting Considerations
The underwriting process examines several critical factors:
- Echocardiogram Results: Most important factor—shows actual heart structure and function
- Murmur Etiology: Whether innocent/functional or from pathological valve disease
- Valve Lesion Specifics: Which valve, stenosis vs regurgitation, severity grading
- Hemodynamic Significance: Pressure gradients, regurgitant fraction, chamber dimensions
- Left Ventricular Function: Ejection fraction and wall motion abnormalities
- Symptoms: Presence of dyspnea, chest pain, syncope, or exercise intolerance
- Surgical History: Valve replacement or repair, type of prosthetic valve
- Disease Progression: Stability versus worsening on serial echocardiograms
- Associated Conditions: Endocarditis history, rheumatic fever, congenital defects
- Treatment Requirements: Medications needed, anticoagulation for mechanical valves
Current Health Assessment
Underwriters require echocardiographic documentation for virtually all heart murmur cases. The echo report provides definitive information about valve structure and function that determines underwriting classification. A simple statement of “heart murmur” without supporting cardiac imaging creates uncertainty that typically results in postponement until appropriate testing is completed.
For innocent murmurs, a single echocardiogram showing structurally normal heart with normal chamber sizes and valve function suffices to document benign status. These applications proceed with no cardiac-related underwriting penalties. For pathological murmurs, underwriters examine the specific valve lesion details—aortic stenosis receives different evaluation than mitral regurgitation—and assess severity based on quantitative echo parameters and functional class.
For more insights on how various medical conditions affect coverage decisions, see our comprehensive guide on Life Insurance Approvals with Pre-Existing Medical Conditions.
Coverage Outlook by Murmur Type and Severity
Your specific murmur characteristics and underlying cardiac status determine realistic coverage expectations. The following classifications reflect typical underwriting practices:
✓ Favorable Outcomes (Standard or Better Rates)
Innocent Murmurs and Minimal Valve Disease:
- Innocent/functional murmur with normal echocardiogram
- Trivial or mild valve regurgitation without chamber enlargement
- Mitral valve prolapse without significant regurgitation
- Grade 1-2 murmur, structurally normal heart
- Asymptomatic with normal exercise tolerance
- No medications required for cardiac condition
- Normal left ventricular function (EF 55%+)
- Stable findings on serial echos if performed
Expected Rating: Preferred to Standard, most innocent murmurs receive preferred rates
⚠ Moderate Risk (Standard to Table Ratings)
Mild to Moderate Valve Disease:
- Mild to moderate aortic stenosis (valve area 1.0-1.5 cm², gradient 25-40 mmHg)
- Moderate mitral or aortic regurgitation with mild chamber enlargement
- MVP with moderate regurgitation
- Asymptomatic but with abnormal valve structure
- Mildly reduced left ventricular function (EF 45-54%)
- Requiring regular cardiology follow-up and monitoring
- Medications needed (beta blockers, diuretics)
- Progressive disease requiring increasing surveillance frequency
Expected Rating: Standard to Table 4, depending on valve specifics and progression
✗ Higher Risk (Table Ratings or Individual Assessment)
Severe Valve Disease or Complications:
- Severe aortic stenosis (valve area <1.0 cm², gradient >40 mmHg)
- Severe valve regurgitation with significant chamber enlargement
- Symptomatic valve disease (dyspnea, angina, syncope)
- Moderately to severely reduced LV function (EF <45%)
- Heart failure from valve disease
- Recent valve surgery or intervention
- Mechanical valve replacement requiring anticoagulation
- Endocarditis history with valve damage
- Multiple valve involvement
Expected Rating: Table 4 to Table 10+, possible postponement or decline for severe untreated disease
Key Underwriting Factors
Several specific elements carry particular weight in heart murmur underwriting decisions. Understanding these priorities helps prepare stronger applications.
Echocardiographic Documentation
The echocardiogram represents the single most important document for heart murmur underwriting. Without echo documentation, underwriters cannot determine whether a murmur is innocent or pathological, creating uncertainty that delays approval or results in conservative rate assumptions. A comprehensive echo report should include:
- Valve structure and function: Description of all four valves with specific attention to the valve creating the murmur
- Quantitative measurements: Valve areas, pressure gradients, regurgitant volumes and fractions
- Chamber dimensions: Left ventricular size and wall thickness, left atrial size
- Systolic function: Ejection fraction calculated by biplane Simpson’s method
- Diastolic function: Assessment of filling pressures if relevant
- Hemodynamic significance: Overall assessment of whether valve lesions are mild, moderate, or severe
Specific Valve Lesions
Different valve conditions receive varying underwriting consideration based on natural history and prognosis:
| Valve Condition | Underwriting Approach |
|---|---|
| Mitral Valve Prolapse | Very common, usually benign. Standard rates typical unless moderate+ regurgitation present |
| Mild Mitral Regurgitation | Standard or better rates common if no chamber enlargement |
| Aortic Stenosis | Severity-dependent. Mild receives standard rates; severe requires intervention and faces table ratings |
| Aortic Regurgitation | Mild chronic AR often tolerated for years. Moderate to severe with LV dilation gets table ratings |
| Tricuspid Regurgitation | Usually secondary to other cardiac disease. Underwriting focuses on underlying cause |
Symptoms and Functional Status
Symptom presence dramatically affects underwriting outcomes for pathological murmurs. Asymptomatic valve disease, even when moderate in severity, receives far more favorable consideration than symptomatic disease. Classic valve disease symptoms that trigger higher ratings include:
- Dyspnea on exertion: Shortness of breath with activity suggests hemodynamic compromise
- Angina: Chest pain from aortic stenosis or other valve lesions
- Syncope: Fainting from severe aortic stenosis, ominous prognostic sign
- Heart failure symptoms: Orthopnea, paroxysmal nocturnal dyspnea, edema
- Exercise intolerance: Marked limitation in physical activities
Asymptomatic individuals with valve disease, even moderate severity, demonstrate that the heart compensates adequately and intervention isn’t immediately necessary. Symptom development typically triggers surgical evaluation and indicates disease progression.
Left Ventricular Function
Ejection fraction and left ventricular dimensions provide critical prognostic information for valve disease. Normal LV function (EF 55%+) with normal chamber sizes suggests the heart tolerates the valve lesion well. Reduced ejection fraction or progressive chamber enlargement indicates decompensation and substantially worsens underwriting outcomes:
- Normal EF (55-70%) with normal LV size: Best outcomes for given valve severity
- Mildly reduced EF (45-54%): Adds table rating beyond valve lesion rating
- Moderately reduced EF (35-44%): Significant additional table ratings
- Severely reduced EF (<35%): May face decline or extreme table ratings
Optimal Timing for Applications
Timing considerations for heart murmur applications depend primarily on whether documentation is complete and whether any interventions are planned.
Ideal Application Windows
Optimal Timing: Documented Innocent Murmur
When: After echocardiogram confirms structurally normal heart
Why: No waiting period needed. Apply immediately once innocent murmur is documented—rates will be excellent.
Documentation Available: Normal echocardiogram report, cardiology clearance if obtained
Acceptable Timing: Stable Mild Valve Disease
When: Mild valve disease diagnosed, asymptomatic, on monitoring protocol
Why: No need to delay if valve disease is documented as mild and stable. Standard rates often available.
Consideration: Having serial echos showing stability over 2-3 years strengthens applications
Challenging Timing: Before Cardiac Testing
When: Murmur identified but no echocardiogram performed yet
Why: Applications will be postponed until echo completed. Better to wait and apply with complete documentation.
Recommendation: Complete all recommended cardiac testing before applying
Poor Timing: Shortly After Valve Surgery
When: Within 6-12 months of valve replacement or repair
Why: Carriers need time to assess surgical outcome and complications. Most postpone 12+ months post-surgery.
Strategy: Wait for surgical recovery and follow-up echos showing good valve function before applying
Special Timing Considerations
Before Planned Intervention: If you have valve disease and surgery or intervention is planned, consider applying beforehand if current status might qualify for coverage. Post-surgical outcomes are unpredictable, and pre-surgical approval may be easier than post-surgical.
During Pregnancy: Many women develop innocent systolic flow murmurs during pregnancy from increased cardiac output. These resolve postpartum. Consider waiting until after pregnancy and documenting normal postpartum echo before applying.
Required Medical Documentation
Comprehensive cardiac documentation is essential for heart murmur applications. The echocardiogram report is mandatory for virtually all cases.
Essential Records
- Echocardiogram Report: Complete transthoracic echo with measurements and images
- Cardiology Consultation: Initial evaluation when murmur was discovered
- Serial Echocardiograms: Follow-up studies if valve disease being monitored
- Exercise Stress Test: If performed to assess functional capacity with valve disease
- Cardiac Catheterization: If performed to assess coronary arteries or measure valve gradients
- Surgical Records: Operative reports and pathology if valve surgery performed
- Current Medications: Any cardiac medications prescribed
Helpful Supplemental Documentation
Additional records that can strengthen applications:
- Cardiology Clearance Letter: Statement about prognosis and recommendations
- Exercise Tolerance Documentation: Records showing maintained physical activity
- Holter or Event Monitor: If performed to assess arrhythmias related to valve disease
- Blood Work: BNP levels if checked, kidney function if on medications
Strategies to Improve Your Application
Several proactive steps can enhance coverage prospects for heart murmur applicants:
Before Applying
- Obtain Complete Cardiac Evaluation: Ensure echocardiogram is performed and documented before applying
- Get Cardiology Assessment: Formal evaluation by cardiologist provides definitive diagnosis
- Update Testing If Old: If last echo is 3-5+ years old, consider repeating before applying
- Document Asymptomatic Status: Ensure medical records clearly state absence of cardiac symptoms
- Optimize Medical Management: If valve disease present, ensure appropriate medications and monitoring
During Application
- Provide Complete Echo Report: Don’t just mention murmur—give full echocardiographic documentation
- Clarify If Innocent: If murmur is innocent, emphasize structurally normal heart from echo
- Detail Stability: If valve disease present, highlight stable findings over time
- Emphasize Function: Document normal exercise tolerance and daily activities
Carrier Selection Strategy
Most major carriers handle innocent murmurs well, but pathological murmurs require more nuanced carrier selection. Some companies have more liberal guidelines for specific valve conditions. Working with brokers who understand carrier-specific cardiac underwriting can substantially improve outcomes for moderate valve disease.
Our Top 10 Best Life Insurance Companies in the U.S. (2025): Expert Broker Rankings can help identify carriers most likely to provide favorable consideration for cardiac conditions.
Alternative Coverage Options
While most heart murmur patients can secure traditional coverage, alternatives exist for those with significant valve disease or complications:
Simplified Issue Life Insurance
These policies use basic health questions without exams. For heart murmurs, simplified issue applications typically ask about heart disease, surgery, and symptoms. Innocent murmurs often qualify without issue. Even mild valve disease may approve if asymptomatic and not recently diagnosed.
Guaranteed Issue Life Insurance
Guaranteed issue policies accept all applicants without medical questions. These work well for individuals with severe valve disease, recent surgery, or symptomatic conditions who face challenges with traditional underwriting. Coverage amounts are limited with graded benefit periods.
For those facing traditional coverage challenges, our guide on Top 10 Best No-Exam Life Insurance Companies (2025 Update) provides valuable alternatives.
Group Life Insurance
Employer-sponsored group coverage typically involves minimal underwriting. Many people with valve disease work successfully and can access valuable group coverage without individual policy scrutiny.
Frequently Asked Questions
Can I get life insurance with an innocent heart murmur?
Yes, absolutely—innocent heart murmurs have zero impact on life insurance rates. Once documented by echocardiogram as innocent (meaning your heart structure is completely normal), you should qualify for preferred or standard rates identical to someone without any murmur. Innocent murmurs are extremely common, particularly in children and young adults, and represent normal variants rather than disease. The key is having echocardiographic documentation confirming the structurally normal heart. Without this documentation, underwriters may postpone until testing is completed, but once innocent status is proven, expect excellent rates.
Do I need to mention a heart murmur if my doctor says it’s innocent?
Yes, you must disclose all medical conditions and diagnoses including innocent heart murmurs. Life insurance applications require complete honesty about all findings even when benign. However, disclosing an innocent murmur with supporting echocardiographic documentation showing normal heart structure actually works in your favor, as it definitively proves there’s no underlying cardiac disease. Never omit medical history as this constitutes material misrepresentation. Instead, view innocent murmur disclosure as an opportunity to demonstrate cardiac health with objective testing.
What if I have mitral valve prolapse? Will this affect my rates?
Mitral valve prolapse (MVP) is very common, affecting 2-3% of the population, and typically has minimal insurance impact if uncomplicated. MVP without significant regurgitation (leakage) and without symptoms usually qualifies for standard rates, possibly standard to Table 2 depending on the carrier. MVP with moderate or greater mitral regurgitation may result in table ratings proportional to regurgitation severity and whether chamber enlargement is present. The key factors are degree of regurgitation, left atrial and ventricular size, presence of symptoms, and left ventricular function. Most people with MVP, which is typically benign, secure reasonable rates.
How does mild aortic stenosis affect life insurance?
Mild aortic stenosis typically qualifies for standard to Table 2 ratings if asymptomatic. Underwriters evaluate aortic stenosis based on valve area (should be >1.5 cm² for mild), mean pressure gradient (should be <25-30 mmHg for mild), symptoms, and left ventricular function. Mild AS that’s stable, asymptomatic, and monitored appropriately with serial echocardiograms receives favorable consideration. Moderate AS (valve area 1.0-1.5 cm²) faces higher table ratings, and severe AS (valve area <1.0 cm²) typically requires intervention before carriers will offer coverage. The disease is progressive, so demonstrating stability over time helps applications.
Can I get coverage after valve replacement surgery?
Yes, but underwriting post-valve surgery is complex and depends on multiple factors. Most carriers postpone applications for 12-24 months after valve surgery to assess surgical outcome and complications. After this period, tissue (bioprosthetic) valves typically receive more favorable consideration than mechanical valves due to no anticoagulation requirement. Expected ratings range from Table 2 to Table 8+ depending on: which valve was replaced, type of prosthetic valve, post-surgical ventricular function, presence of complications, and time since surgery. Successful valve surgery with excellent outcome may receive Table 2-4 ratings, while complicated surgery or poor function faces higher ratings or possible decline.
What grade of murmur matters for insurance purposes?
Murmur grade (intensity on a 1-6 scale) matters far less than the cause of the murmur. An innocent Grade 2 murmur receives perfect rates, while a pathological Grade 2 murmur from severe aortic stenosis might face table ratings or worse. Grade correlates imperfectly with severity—loud murmurs can be innocent while soft murmurs might reflect serious disease. Underwriters care about echocardiographic findings showing actual valve structure and hemodynamics, not the auscultatory grade documented on physical exam. Never assume a high-grade murmur automatically disqualifies you or that a low-grade murmur guarantees good rates. The echocardiogram determines everything.
How often do I need echocardiograms to maintain life insurance?
Once you have life insurance coverage, you don’t need to provide updated echocardiograms unless you apply for additional coverage. Your initial policy remains in force regardless of how your valve disease progresses, as long as you pay premiums and didn’t provide false information during application. However, if your valve condition has worsened significantly and you need more coverage, new applications will require current cardiac testing. For initial applications, the most recent echo is used—carriers typically want testing within 2-3 years for stable mild disease, or more recent for moderate to severe disease. Serial echos showing stability over time strengthen applications.
Ready to Explore Your Life Insurance Options with a Heart Murmur?
Most people with heart murmurs qualify for excellent rates, particularly those with innocent murmurs. Our specialized team understands cardiac conditions and works with carriers experienced in valve disease underwriting to secure your best possible coverage and rates.
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Disclaimer
This information is for educational purposes only and does not constitute medical or insurance advice. Individual coverage availability and pricing depend on personal health factors, murmur etiology, valve disease severity, cardiac function, and insurance company guidelines. Consult with licensed insurance professionals for guidance specific to your situation.
Medical Information Disclaimer
This article provides general information about life insurance for individuals with heart murmurs, offered for educational purposes. Individual circumstances vary significantly, and outcomes depend on numerous factors including murmur cause, valve disease type and severity, cardiac function, symptoms, surgical history, and comorbid conditions. All consultations are confidential and comply with HIPAA privacy requirements.
