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Hole in the Heart – Causes, Symptoms & Treatment

A normal heart is divided into two sides, the left and the right, separated by a wall known as the septum. The right side of the heart receives blood poor in oxygen and sends it towards the lungs. Replenished with oxygen, the blood returns from the lungs and empties into the left side of the heart, to be pumped to the body. It is the septum that prevents the mixing of blood between the two sides. However, some babies are born with a hole in the heart septum, at the upper or lower walls. A hole in the septum dividing the upper left and right heart chambers is known as Atrial Septal Defect (ASD) and a septum hole of the lower chambers is known as Ventricular Septal Defect (VSD). Rising awareness about symptoms of heart attack in men and women may contribute towards lowering the occurrence of heart attacks as well as a hole in the heart cases.

In both ASD and VSD, purified blood in the left chamber mixes with oxygen-deficient blood on the right side. A large hole in ASD can cause lungs to overfill with blood and make the heart work harder. The picture attached below helps to diagrammatically explain the structure of the heart and enable you to understand the case of hole in the heart better.

What are the causes of hole in the heart?

ASD and VSD are congenital heart defects. As per a trusted cardiologist in Mumbai, typical causes of the hole in the heart defect are the following:

  • Genetics:
    A child may be at a higher risk of septal defect if either parent has a congenital heart defect. However, it is quite rare for a family to have more than one child with the defect.
  • The presence of other genetic disorders:
    Children with a hereditary disorder like Down syndrome often also have a heart defect from birth.
  • Smoking:
    Babies born to mothers who smoked during pregnancy are prone to various congenital heart defects like ASD and VSD.
    Read more about symptoms of Congenital Heart Defects.

Still, there are a lot of unknown factors contributing towards the various causes of hole in the heart. Therefore, scientists and doctors are working tirelessly to discover and research upon the various causes of hole in the heart.

What are the Symptoms of Hole in Heart?

At times, hole in the heart symptoms can be so trivial that its impact does not appear for many years or until adulthood, while at other times, it may require immediate attention. On the same line, according to a renowned cardiologist, many babies do not show symptoms of ASD. However, the symptoms may begin in adulthood around the age of 30 or even later. Signs of ASD include:

  • Heart murmur
  • Fatigue
  • Shortness of breath, palpitations
  • Bluish skin color
  • Swelling of feet, legs or abdomen
  • Stroke

Symptoms of VSD manifest soon after the birth of the baby, in the first few days, weeks or months itself. Signs include:

  • Cyanosis, or bluish lips, skin and fingertips
  • Rapid breathing
  • Poor appetite
  • Swelling of feet, legs or abdomen
  • Heart murmur (could be the only sign of the defect in some babies)

Which Specialist should be Consulted in a case of Signs and Symptoms of Hole in Heart?

A child or adult with a septal defect or heart hole is referred to a cardiologist.

What are the Screening Tests done to Confirm or Rule out the Disorder?

ASD and VSD are diagnosed through the following:

  • Physical exam – The doctor listens to the heart and lungs with a stethoscope for a heart murmur
  • Echocardiography
  • Electrocardiogram (EKG)
  • Chest x-ray
  • Cardiac catheterization
  • Pulse oximetry

What Treatment Options are available for Management of the disorder?

Heart hole or heart defects, in general, are the leading cause of death in birth defect related deaths. Although, the number is declining with the advances in health care over the past few decades increasing the chances of survival. As far is, hole in the heart cases is considered, many ASDs close on its own in the first year of the child’s birth. Based on regular check ups, a doctor may suggest treatment on children with a medium or large hole in the heart at two to five years of age. Treatment generally involves surgical or catheter procedures to seal the heart hole

  • Catheter Procedure:
    Performed under anesthesia, the procedure involves inserting a catheter into the vein of the groin and threading it up towards the septum. Two small discs that are attached to the catheter are pushed out, plugging the hole between the heart’s atria. Normal tissue grows around the device in six month’s time.
  • Surgery:
    An incision in the chest allows the surgeon to cover the heart hole with a special patch.

Ventricular septal defects are usually monitored if they do not cause any symptoms. In case treatment is required, it is done through:

  • Extra Nutrition:
    Special feeding or nutrition is required in some babies who do not develop as well as they should. Breast milk supplements, high-nutrition formulas, tube feeding or bottle-feeding may be needed.
  • Surgery:
    Large VSDs may require open-heart surgery that fixes patches to close the septum.

What Precautions or steps are necessary to stay Healthy during the Treatment of Hole in the Heart?

Children and teens with repaired ASD or VSD should undergo regular follow-ups with the doctor to monitor progress. Adults undergoing treatment must follow the doctor’s guidelines before returning to normal activities. Also, exercise is good for your heart, as long as you stay within your cardiologist’s guidelines.