Hole in Heart: Symptoms, Causes, Life Expectancy

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Medically Reviewed by Dr. Aman Priya Khanna
Written by Kirti V, last updated on 15 December 2023| min read
Hole in Heart: Symptoms, Causes, Life Expectancy

Quick Summary

  • A hole in the heart is a type of congenital heart defect.
  • It is present in the muscular wall, separating the right and left chambers of the heart.
  • Symptoms include bluish discolouration of the skin, tiredness, heart murmur, pulmonary hypertension and stroke.

A hole in the heart is one of the most common heart defects seen in infants. It is a type of congenital heart defect. The hole is present in the muscular wall, separating the right and left chambers of the heart.

According to a study by Saxena in the year 2018, it was reported for every 1000 babies, nine are born with a congenital heart defect. Read below to know about this condition, including symptoms, causes and treatment options.

Disease Name

Hole in heart

Alternative Name 

Atrial Septal Defect (ASD), Ventricular Septal Defect (VSD)

Symptoms

Bluish discolouration of the skin, Tiredness, Heart murmur, Pulmonary hypertension, Stroke

Causes

Genetic, Consumption of alcohol or smoking during pregnancy

Diagnosis

Echocardiogram, CT scan, MRI, X-ray

Treated By

Cardiologist, Cardio surgeon

Treatment Options

Catheter-based repair, Open heart surgery

What is a Hole in the Heart?

A hole in the heart is a nonmedical term used commonly for a congenital heart defect. It is characterised by the presence of a hole, which occurs due to structural abnormality.

This heart structure issue is known as an atrial septal defect when it occurs between the two atria and as a ventricular septal defect when it happens between the ventricles. 

The effect of a heart hole on health varies based on its size and where it's located. Small holes might not have noticeable symptoms and might naturally close up. But bigger ones require medical attention because they can result in issues like pulmonary hypertension and heart failure.

A baby with a hole in the heart can grow up normally and lead an active and healthy life with appropriate medical care.

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Types of Holes in the Heart

Several types of holes in the heart can occur, and they are often congenital, meaning they are present from birth. These holes can affect the normal flow of blood through the heart and the body. These holes in the heart can vary in size and severity. The main types are:

  1. Atrial Septal Defect (ASD): This is a hole in the wall (septum) that separates the two upper chambers of the heart, known as the atria. It allows oxygen-rich blood from the left atrium to mix with oxygen-poor blood in the right atrium, which can lead to various heart and lung problems.
  2. Ventricular Septal Defect (VSD): This type of hole occurs in the wall between the two lower chambers of the heart, called the ventricles. It allows oxygen-rich blood from the left ventricle to mix with oxygen-poor blood in the right ventricle, resulting in an increased workload on the heart.
  3. Patent Foramen Ovale (PFO): A PFO is a small hole in the septum between the atria. It is a remnant of a fetal opening necessary for blood circulation in the womb. While it usually closes shortly after birth, it can remain open in some individuals. A PFO may not cause symptoms but can be associated with certain medical conditions.
  4. Patent Ductus Arteriosus (PDA): This is a connection between two major blood vessels near the heart, the pulmonary artery and the aorta. Normally, this connection closes shortly after birth, but in some cases, it remains open. An open PDA can increase blood flow to the lungs and heart.

Hole in Heart Symptoms

Small holes (less than 5 mm) do not result in any considerable passage of blood through them and thus do not cause enough strain on the heart or lungs to result in symptoms. The larger holes in the heart, however, may cause any of the following symptoms:

  1. Heart murmur and palpitations
  2. Rapid heart rate
  3. Cyanosis (bluish discolouration of the skin)
  4. Frequent respiratory tract infections in children
  5. High blood pressure
  6. Migraine
  7. Shortness of breath
  8. Getting tired easily
  9. Swelling in the extremities (arms and legs) or abdomen
  10. Stroke
  11. Transient ischemic attack
  12. Heart failure

What Causes a Hole in the Heart?

The heart is divided into four chambers - two on top called atria and two below called ventricles. These chambers are separated by a wall known as the septum, which is made up of different parts that come together as a baby develops in the womb. 

Normally, these parts fully connect to create a solid wall. But in certain situations, they don't fuse completely, and this can result in a gap. The causes are:

  1. Congenital Heart Defect: A heart hole can develop before birth due to abnormal development of the heart during pregnancy.
  2. Environmental Factors: Exposure to toxins or radiation during pregnancy may contribute to heart defects.
  3. Infections: In some cases, maternal infections during pregnancy, such as rubella, may lead to heart defects in the developing fetus.

Hole in the Heart Risk Factors

While the exact cause of a hole in the heart is not always known, certain risk factors are believed to raise the likelihood of a baby being born with a hole in the heart. These include:

  1. Genetics: A positive family history of congenital heart defects, including holes in the heart, is considered to raise the risk for other family members.
  2. Premature Birth: In babies born prematurely, the heart of the baby is still developing. The wall might not have closed completely by the time of the birth and may present as a hole in the heart.
  3. Maternal Factors: Maternal Factors: Certain maternal factors during pregnancy, such as diabetes or exposure to certain medications or infections, can increase the risk of a heart hole in the baby.
  4. Advanced age (above 35 years) Pregnancy: It may slightly raise the risk of congenital heart diseases, including holes in the heart. This may happen because older age women have a greater tendency to suffer from chronic conditions like hypertension, diabetes, etc. The quality of the egg also deteriorates with age.
  5. Chromosomal Disorders: Certain chromosomal disorders, such as Down's syndrome, are associated with a higher risk of congenital heart defects. Almost half of the children with Down's syndrome have CHD.

Prevention of Hole in the Heart

Though prevention of this condition is not possible, precautions can be taken. These include:

  1. Healthy Lifestyle: Maintain a balanced diet, exercise regularly, and manage your weight to reduce the risk of heart defects.
  2. Prenatal Care: If you're pregnant or planning to be, seek proper prenatal care. Regular check-ups with a healthcare provider can help monitor the baby's development and detect any issues early.
  3. Avoid Harmful Substances: Steer clear of alcohol, tobacco, and recreational drugs during pregnancy, as these substances can increase the risk of heart defects in the developing baby.
  4. Manage Chronic Conditions: If you have chronic health conditions, like diabetes, it's crucial to keep them under control during pregnancy to minimize the risk of heart defects.
  5. Medications: Ensure that any medications you take are safe during pregnancy, and consult with a healthcare provider if you have concerns.

How is a Hole in the Heart Diagnosed?

Diagnosing a hole in the heart involves several steps to determine the presence and type of defect. The cardiologist will recommend the following to diagnose:

  1. Physical Examination: A doctor may conduct a physical exam to listen to the sounds of the heart and check for any unusual signs, such as abnormal heart murmurs.
  2. Medical History: The doctor will ask about your medical history, including any family history of heart conditions and any symptoms experienced.
  3. Imaging Tests: To confirm the diagnosis, various imaging tests may be used, including:
    Electrocardiogram (ECG or EKG): This test records the electrical activity of the heart and can help identify abnormal rhythms.|
    Echocardiogram: This is a painless ultrasound test that provides real-time images of the heart. It can reveal the presence and type of hole in the heart.
    Chest X-ray: It provides images of the chest to see the size and structure of the heart.
  4. Electrocardiogram (ECG or EKG): This test records the electrical activity of the heart and can help identify abnormal rhythms. 
  5. MRI (Magnetic Resonance Imaging): This advanced imaging technique may be used to provide more detailed images of the heart and its blood flow.
  6. CT Scan (Computed Tomography): A CT scan can offer a three-dimensional view of the heart and help diagnose specific heart defects.

How to Prepare for the Doctor Consultation?

If the baby is exhibiting some symptoms suggestive of a hole in the heart, the parents need to get the baby examined by a physician. For a fruitful visit, consider the below-mentioned recommendations:

  1. Make a prior appointment to avoid long waiting hours at the hospital.
  2. If the baby has been diagnosed with a hole in the heart, ask the doctor about its size, severity, what are the chances of it getting closed on its own and how much time that can take.
  3. If the doctor is advising surgery, enquire if it is possible through a minimally invasive approach or if open-heart surgery will be required. You can also ask about the possible risks of the surgery and the estimated recovery time.

Expectations from the Doctor

While visiting a doctor for consultation regarding a hole in the heart, be prepared to expect the doctor to do one or more of the following:

  1. The doctor will do a physical examination to look for the symptoms and hear the heart sounds through a stethoscope to detect any murmur.
  2. The physician will ask if any other family members also have congenital heart disease.
  3. The doctor may ask if the mother suffered from any medical conditions during pregnancy.
  4. Depending on the findings, the doctor may recommend further investigative tests or imaging.
  5. The doctor may suggest the best treatment approach for the patient, which should be followed for the best outcomes.
  6. The physician may refer the patient to a superspecialist doctor, such as a pediatric cardiologist.

Hole in Heart Treatment

Many a time, the hole in the heart closes on its own as the child grows. However, sometimes it may not. In such cases, if they are large enough to adversely affect the health of the heart or lungs, they need to be closed surgically.

Non-surgical Treatments of Hole in the Heart

If surgery is not possible due to some reason or while waiting for the hole in the heart to close on its own, management of the condition can be done by the following methods:

Home Remedies

Although home remedies cannot be considered a treatment for a hole in the heart, they can help to some extent in preventing and managing the symptoms:

  1. Dietary Modifications: Include foods with antioxidant and anti-inflammatory properties, such as flaxseed and garlic, as they are healthy for the heart. Take omega-3 fatty acids, coenzyme Q-10, or vitamin K2 supplements. These are considered to lower the risk of cardiac diseases and also optimise heart function.
  2. Lifestyle Modifications: Some lifestyle changes are suggested for people with holes in their hearts. Manage a healthy weight to avoid symptoms like shortness of breath and tiredness. Avoid strenuous activities that can strain the heart.

Alternative Treatment

Many people have faith in alternative treatment approaches like Ayurveda and Homeopathy for the treatment of heart conditions like a hole in the heart. Find below the best options in alternative forms of therapy:

  1. Ayurveda: Ayurveda has the power of tissue generation of some herbs to treat holes in the heart. Amlaki is one such herb that is believed to be a potent rejuvenator in Ayurveda.
  2. Homoeopathy: Homoeopathic medicines like Phosphorus 30,200, Sulfur 200, Calc Phos 6x, Apis and Lachesis are used to treat ASD(6).

Surgical Treatment of Hole in the Heart

Many cardiologists advise surgery for a moderate to large atrial septal defect after it is diagnosed in childhood or adulthood. After undergoing atrial septal defect surgery, regular check-ups and echocardiograms are vital for monitoring potential complications.

The surgical treatment of ASD are:

  1. Cardiac Catheterization: This method involves inserting a thin, flexible tube (catheter) into a blood vessel, typically in the groin, and guiding it to the heart using imaging techniques. A mesh patch or plug is passed through the catheter to seal the hole. Over time, heart tissue grows around this seal, permanently closing the opening.
  2. Open-Heart Surgery: This type of surgery requires an incision through the chest wall to directly access the heart. Cardiac surgeons employ patches to close the hole. Occasionally, minimally invasive surgery with small incisions or robot-assisted heart surgery can also be used.

Cost of Hole in the Heart Treatment

The cost of open heart surgery in India can vary depending on several factors, including the type of surgery, the hospital or clinic where the procedure is performed, and the location. Here is a table highlighting the cost of the surgery:  

Name of Surgery

Cost 

Open Heart Surgery

₹ 3,00,000 - ₹5,00,000

Risks and Complications of Hole in the Heart

Depending on the type and size of the hole in the heart, there may be a wide range of complications. Small ASDs or VSDs may never be of concern and frequently close on their own over time. The risks of the hole in the heart are:

  1. Heart Strain: A hole in the heart can cause extra blood to flow through the heart, which may lead to strain and enlargement of the heart chambers over time.
  2. Irregular Heartbeats (Arrhythmias): Some individuals with heart defects may be at a higher risk of developing irregular heart rhythms. It affects the ability of the heart to pump blood effectively.
  3. Pulmonary Hypertension: In some cases, increased blood flow to the lungs can result in high blood pressure in the lung arteries (pulmonary hypertension), which can strain the heart.
  4. Heart Valve Problems: The altered blood flow patterns associated with a heart defect can cause damage to heart valves, leading to leakage or narrowing.
  5. Stroke: In rare cases, a hole in the heart can allow small blood clots or debris to travel from the right side of the heart to the left side and then to the brain, potentially causing a stroke.
  6. Heart Failure: In severe cases or when the defect remains untreated, it can result in heart failure, where the heart cannot pump blood effectively to meet the body's needs.

When to Consult a Doctor for a Hole in Heart?

Prompt diagnosis and treatment play a vital role in successfully treating a hole in the heart. Thus, if the baby is showing symptoms suggestive of this condition, do not delay visiting a doctor. The symptoms that warrant a consultation with a doctor are:

  1. Getting tired easily while feeding or playing
  2. Getting short of breath while crying
  3. Rapid heart rate
  4. Poor weight gain
  5. Frequent respiratory infections

Diet for Hole in Heart 

For individuals with a heart defect, it's essential to maintain a heart-healthy diet to support overall well-being. The diet may include the following:

  1. Balanced Diet: A balanced diet should include a variety of foods from all food groups, like fruits, vegetables, lean proteins, whole grains, and low-fat dairy products.
  2. Limit Salt: Reducing salt intake is essential as it can help control blood pressure. Avoid adding extra salt to your meals, and be cautious of high-sodium processed foods.
  3. Healthy Fats: Opt for unsaturated fats found in foods like olive oil, nuts, seeds, and fatty fish (like salmon and mackerel). These fats can support heart health.
  4. Fibre-Rich Foods: Include plenty of fibre in your diet through whole grains, fruits, and vegetables. Fiber aids in digestion and can help manage cholesterol levels.
  5. Limit Sugary and Fatty Foods: Reduce the consumption of sugary beverages, sweets, and high-fat, processed foods. These can contribute to weight gain and unhealthy cholesterol levels.
  6. Moderate Portion Sizes: Be mindful of portion sizes to prevent overeating, which can lead to weight gain and strain on the heart.

Takeaway

While a hole in the heart may initially seem daunting and present challenges, it is comforting to know that this is a manageable condition. With continued research and innovations in the treatments available nowadays, the prognosis of patients with a hole in the heart continues to get brighter.

HexaHealth is a health-tech platform facilitating connections between patients and top-tier medical facilities in India. It can be trusted to provide unbiased and fair recommendations to its users. It strongly believes in the patient-first ideology and provides patients with a curated list of hospitals that best match their specific needs.

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Frequently Asked Questions

A congenital cardiac abnormality known as a hole in the heart occurs when the wall between the heart's lower and upper chambers, the ventricles and the atria, respectively, has a hole in it. This is a condition that is present from birth.

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A congenital cardiac defect hole in the heart is also known medically as ventricular septal defect (VSD) or atrial septal defect (ASD).

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The different types of holes in the heart are:

    1. Patent Foramen Ovale (PFO)

    2. Atrial Septal Defect

    3. Ventricular Septal Defect

    4. Patent Arteriosus Ductus (PDA)

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In a normal heart, there is no hole present. However, there are holes in some congenital heart defects such as ASD and VSD. In these cases, there may be just one hole or can be more than one hole. The sizes of the holes also vary from patient to patient.

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Smaller holes in the heart (less than 5 mm) usually do not cause symptoms. The larger holes, however, may present with symptoms in the first few days, weeks or months of a child's life.

Hole in the heart baby symptoms generally consist of:

  1. Difficulty feeding
  2. Failure to thrive
  3. Rapid breathing
  4. Murmur
  5. Poor growth
  6. Frequent respiratory infections

Adults may have the following hole-in-the-heart symptoms:

  1. Murmur
  2. Difficulty breathing, especially after exercising
  3. Swelling of the extremities and abdomen
  4. Easy tiring

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It is unclear as to what causes a hole in the heart in an infant. ASD or VSD is a structural issue that develops during the development of the baby's heart while they are still in the womb.

These could be factors that might cause a hole in the heart in a baby:

    1. Genetics

    2. Specific illnesses

    3. Usage of specific drugs

    4. Environmental or lifestyle factors of the mother, such as smoking or drinking alcohol

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A hole in the heart is almost always present at birth. Very rarely, however, an adult can get a hole in the heart following a heart attack if the septal wall becomes very thin and perforates due to infarction. Sometimes, a hole in the heart can also be caused due to an injury during cardiac surgery.

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A baby may be more likely to be born with a hole in the heart or other congenital heart abnormalities if certain medical conditions are present in the mother or due to the usage of some medicines or substances during pregnancy. These include:

    1. Infection with German measles (rubella) in the early stages of pregnancy

    2. Diabetes

    3. Lupus

    4. Use of tobacco or alcohol

    5. Usage of illicit drugs such as cocaine

    6. Use of specific medications such as some anti-seizure, blood pressure medicines and those for treating mood disorders

    7. Family history of congenital heart disease

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Yes, a hole in the heart is a congenital condition and develops when the baby is still in the womb during the development of the heart of the baby.

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One or more of the following tests are used for the diagnosis of a hole in the heart:

    1. Echocardiogram

    2. ECG

    3. Pulse oximetry

    4. Chest X-ray

    5. Exercise stress test for adults

    6. Cardiac catheterisation

    7. Foetal echocardiogram

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ECG (electrocardiography) is used to evaluate the electrical activity of the heart and diagnose arrhythmia, which can arise due to a hole in the heart. However, ECG is not a confirmatory test to detect a hole in the heart.

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Many heart holes close naturally in the first few months after birth. The heart holes that do not close on their own may need to be closed surgically via open-heart surgery or catheter-based procedures.

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The size of the hole and whether or not the hole is repaired are two of the many variables that affect life expectancy. Repair time is also important. According to research, those who have their heart holes repaired early in life have a better prognosis.

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Yes, smaller holes, less than 5 mm in size, usually close on their own naturally. The larger ones may require medical treatment for closure.

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Babies born with small holes in the heart may just need regular checkups and medications to treat any symptoms. However, if the heart holes are medium to large, then the only treatment option is surgery.

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The treatment of structural abnormalities like a hole in the heart, often known as a congenital heart defect, usually involves surgery. There is no proven natural treatment for this condition, although some milder cases might not need surgery and the symptoms can be managed with medicine and lifestyle adjustments.

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Smaller holes in the heart might never be problematic, but medium or large heart holes can cause complications such as:

    1. Heart failure

    2. Endocarditis

    3. Heart valve disease

    4. Arrhythmias

    5. Eisenmenger syndrome

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If you or your child has a hole in the heart, your doctor may advise making some lifestyle modifications to maintain heart health and prevent complications, such as:

    1. Practicing safe exercises

    2. Sports and activity restrictions

    3. Maintaining a healthy weight

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If you have a hole in your heart that has not been repaired, then you should avoid certain strenuous activities to prevent getting short of breath and fatigued. Also, it might be advisable to avoid going at a high altitude or scuba diving as a change in altitude may cause concern.

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Many advancements have been made in this field in recent years. Open-heart surgery was the only option earlier. However, nowadays, innovative catheter-based procedures are frequently used to close the holes in the heart. These are much safer and minimally invasive techniques, has shorter recovery time, and are less expensive than open-heart surgeries.

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Early detection and prompt treatment for holes in the heart is of paramount importance and is a game changer in increasing the life expectancy and quality of life of patients. It also helps in the prevention of complications.

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Without proper treatment, a hole in the heart may even cause death. This may happen because, in the long run, it can result in life-threatening complications such as pulmonary hypertension, heart failure, lung failure, or arrhythmia.

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If treated early, most children and adults with congenital cardiac defects can live a normal, healthy life with no reduction in lifespan. They may only need intermittent follow-ups with a cardiologist.

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References

All the articles on HexaHealth are supported by verified medically-recognized sources such as; peer-reviewed academic research papers, research institutions, and medical journals. Our medical reviewers also check references of the articles to prioritize accuracy and relevance. Refer to our detailed editorial policy for more information.


  1. Saxena A. Congenital Heart Disease in India: A Status Report. Indian Pediatrics [Internet]. 2018 Dec 15;55(12):1075–82. link
  2. Atrial Septal Defect (ASD): Symptoms, Causes, Tests and Treatments [Internet]. Cleveland Clinic. link
  3. Hole in heart: Symptoms, causes, treatment, and more [Internet]. www.medicalnewstoday.com. 2022. link
  4. Cleveland Clinic. Ventricular Septal Defects (VSD): Symptoms, Treatment & Outlook [Internet]. Cleveland Clinic. 2021. link
  5. Closing Holes in the Heart | SCAI - Seconds Count [Internet]. www.secondscount.org. link
  6. Mayo clinic. Ventricular septal defect (VSD) - Symptoms and causes [Internet]. Mayo Clinic. 2018. link
  7. American Heart Association . Patent Foramen Ovale (PFO) [Internet]. www.heart.org. 2011. link
  8. Heart hole treatment by Dr. Yogesh Jadhav | homeopathy clinic in Aurangabad [Internet]. advancedspecialityhomeopathyclinic.com. link

Updated on : 15 December 2023

Disclaimer: The information provided here is for educational and learning purposes only. It doesn't cover every medical condition and might not be relevant to your personal situation. This information isn't medical advice, isn't meant for diagnosing any condition, and shouldn't replace talking to a certified medical or healthcare professional.

Reviewer

Dr. Aman Priya Khanna

Dr. Aman Priya Khanna

MBBS, DNB General Surgery, Fellowship in Minimal Access Surgery, FIAGES

12 Years Experience

Dr Aman Priya Khanna is a well-known General Surgeon, Proctologist and Bariatric Surgeon currently associated with HealthFort Clinic, Health First Multispecialty Clinic in Delhi. He has 12 years of experience in General Surgery and worke...View More

Author

Kirti V

Kirti V

B.A. English | M.A. English ( Magadh University, Bihar)

3 Years Experience

With 3 years of full-time experience as an SEO content writer, she has honed her skills to deliver captivating and persuasive writing that leaves a lasting impact. She is always ready to learn new things and expand...View More

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