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Hello. Thanks for writing in. My name is***** and I would be happy to help you. If there is a murmur, then it is related to heart disease. At her age, she would have outgrown any murmur as a kitten if it was an innocent murmur. A murmur doesn't necessarily mean significant heart disease, though. It may be sub-clinical and not give her any problems at all. This is the same in a lot of people as well. In order to fully evaluate the heart, the echocardiogram is a must. There is no way around it, and it is recommended to do so to get a baseline reading. If there is some significant increase in size or changes in the heart, then it is possible she may need to go on medication to decrease the amount of work the heart has to do in order to pump the extra blood volume from the back flow of blood in the heart (what causes the murmur). Your vet can do an x-ray of the chest to see if there is general enlargement of the heart, but the echo is necessary to look at the heart chambers, valves and heart wall thickness, which is important. Please let me know if you have any other questions or concerns. If you are satisfied with my response, please rate it. Hope this helps.