Dear Doctor: My 7-year-old niece has been diagnosed with a heart murmur, and my brother says she won’t be receiving any kind of treatment. What is a heart murmur? Will it interfere with the activities she loves, like soccer and softball?

Dear Reader: When someone has a heart murmur, it means an extra and unusual sound has been detected while their heart beats.

During the normal cycle of a heartbeat, blood is propelled through the chambers of the heart via muscle contractions, and its flow is directed by a series of valves that open and close in a specific sequence and pattern. The normal two-part sound of a heartbeat, which is often described as lub-DUB, is made by the heart valves as they close. When someone has a heart murmur, their heartbeat makes a whooshing or swishing sound. This is caused by turbulent blood either within or near the heart. We know that all of this can sound alarming, but a heart murmur isn’t necessarily dangerous and doesn’t automatically require treatment. A heart murmur may be congenital, which means you are born with it, or it can develop later in life.

The condition is divided into two categories -- innocent or abnormal. Innocent heart murmurs, sometimes also referred to as functional or normal murmurs, don’t pose a danger to the individual and generally don’t require treatment. An innocent heart murmur is a common finding in children and infants. In the majority of cases, no structural abnormalities to either the heart or the vessels that serve it are present. In fact, researchers estimate that fewer than 1% of childhood heart murmurs are associated with congenital heart disease.

An abnormal heart murmur can be caused by structural problems that interfere with optimal cardiac function. These can include valve abnormalities or septal defects, which are holes in the heart. Infections, such as rheumatic fever, can lead to a heart murmur. So can endocarditis, which is an infection of the heart’s inner lining.

In some people, an abnormal heart murmur is accompanied by symptoms such as shortness of breath, a bluish tinge to the skin or lips, chest pain, rapid breathing, a chronic cough or light-headedness. Abnormal heart murmurs require treatment, which can range from medications to manage the condition, to surgery to repair the structural causes.

The fact that your niece has seen a doctor and won’t receive treatment suggests she has an innocent murmur. However, her doctor will continue to monitor the murmur throughout her childhood. If problems arise, she will be referred to a pediatric cardiologist, who may use an X-ray, electrocardiogram or echocardiogram to learn more about her heart and the murmur.

For the majority of children living with an innocent heart murmur, life goes on as normal. They can run, ride bikes, jump rope, go swimming and play sports. If she begins to exhibit any of the symptoms we mentioned earlier, then she will need to be reevaluated. But the good news is that in many cases, innocent heart murmurs resolve by themselves by adulthood.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: Now that it’s harder see a doctor or go to the emergency room, I want to beef up our first-aid kit. What should we have on hand?

Dear Reader: We’re big fans of maintaining a well-stocked first-aid kit and agree that having the right supplies on hand is particularly important right now. We’ll go a step further and suggest that you keep an edited version of the home kit in each car.

Your first step is to identify your family’s specific needs. If someone has a food allergy or a respiratory condition, such as asthma, you’ll want to stock extras of the medications you use to manage those conditions. Be sure to clearly mark each medication with its expiration date.

When it comes to general items, think in terms of the types of medical situations that require prompt attention. These include skin injuries, such as cuts, scrapes, burns, rashes and splinters; mishaps such as pulled muscles or strained ligaments; infections such as a sore throat or a cold; and common allergic reactions such as poison oak, poison ivy and insect stings. Buy the products you’re familiar with and that you’ve had success with in the past.

We also think it’s wise to invest in a good first-aid handbook, which will guide you through the diagnosis and treatment of the mishaps that can occur at home. Leaf through it before stowing it with your gear. Knowing in advance how to approach a burn, cut or sprain will lessen everyone’s stress during an emergency, and it will improve the quality of the first-aid care you’re rendering. Make learning the ropes a family enterprise so everyone can help each other.

First-aid supplies for a family of four should include:

-- 25 adhesive bandages of assorted sizes

-- Antibiotic ointment and antiseptic wipes

-- Aspirin

-- An instant cold compress

-- 2 absorbent compress dressings

-- 1 adhesive cloth tape

-- Nonlatex gloves to be worn when dealing with blood or bodily fluids

-- Hydrocortisone ointment

-- A pair of scissors and a set of tweezers

-- A 3-inch and a 4-inch roller bandage

-- 10 sterile gauze pads (3-by-3 inches and 4-by-4 inches)

-- An oral thermometer that is not glass and does not contain mercury -- and if your thermometer uses batteries, be sure to stock extras

Additional items you may consider include antacid tablets, antidiarrhea meds, a bee-sting kit, a small mirror and blunt-tip scissors. Store everything in a waterproof container that’s easy to open and easy to carry. Something with separate compartments is best so you can easily see and reach the items you need. Use one of the compartments for the family-specific items we talked about earlier. Bathrooms tend to be damp environments, so store your supplies somewhere else, such as a linen closet or kitchen pantry.

Finally, be sure to set up and maintain a first-aid kit checklist. You’ll use this to replenish supplies as you use them, and to keep track of all medications with expiration dates. This is also a good spot to include all of the emergency phone numbers you rely on.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: I wonder if you could help me with a problem that robs me of sleep, and which lately even persists during the day. I’m referring to restless leg syndrome. What causes it? Are there any new findings about getting relief?

Dear Reader: Restless leg syndrome, which is also known as Willis-Ekbom disease, is a condition in which someone has an uncontrollable need to continually move or flex the muscles in their legs. This is due to unusual and unpleasant sensations such as throbbing, crawling, pulling, tingling or itching, which only subside during movement.

Restless leg syndrome, or RLS, can happen to anyone and at any stage of life. Up to one-third of pregnant women report that they experience RLS symptoms, and the condition occurs in children as well. It’s seen more often in women than in men, and it is most common among older adults. Although it can affect any part of the body, most people experience symptoms in the muscles of their calves or thighs.

RLS symptoms, which become more frequent in the late afternoon and evening, typically begin when someone is at rest. The sensations are so persistent they can’t be ignored. Although flexing the muscles, standing or walking can bring relief, as soon as someone is at rest again, the symptoms return. Like you, the majority of people living with RLS also experience twitching and jerking movements that interfere with sleep. These can occur two or three times per minute throughout the night and often lead not only to sleep deprivation, but also to anxiety and depression.

Although the exact cause of RLS remains unknown at this time, research links it to a disruption in a region of the brain known as the basal ganglia, which is associated with movement. This part of the brain uses dopamine, a brain chemical crucial to smooth and sustained motion. There is also evidence that low levels of iron in the brain may play a role. Drug treatment focuses on opioids, medications to amplify dopamine, antiseizure drugs and certain sleep medications. Each of these comes with potential side effects, so it’s important to discuss the pros and cons with your doctor.

Lifestyle changes such as a moderate exercise program, stretching, massage, warm baths, cutting back on alcohol and tobacco use, and the use of heat or ice packs can ease symptoms. Some people with RSL find relief with a foot wrap, approved by the FDA, which applies pressure to two muscles in the foot. Another device provides pressure and vibration along the backs of the legs. Both of these have been found to help ease RLS symptoms.

A small study by researchers at the Stanford Center for Sleep Sciences and Medicine recently found that people with RLS may have an imbalance in certain kinds of bacteria in their gut. This echoes the gut-brain connection currently being explored in Parkinson’s disease, which also involves a loss of dopamine that affects movement. More research is needed, but this line of inquiry holds promise for new and more effective directions in treatment.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)